Provider Demographics
NPI:1154641090
Name:WOHLFEIL, TODD W (DPT)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:W
Last Name:WOHLFEIL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52503 STAFFORD DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-3816
Mailing Address - Country:US
Mailing Address - Phone:586-430-1333
Mailing Address - Fax:586-430-4691
Practice Address - Street 1:52503 STAFFORD DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-3816
Practice Address - Country:US
Practice Address - Phone:586-430-1333
Practice Address - Fax:586-430-4691
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015219225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist