Provider Demographics
NPI:1194357301
Name:DAWKIN, MICHELLE KEI (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:KEI
Last Name:DAWKIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 MANHASSET CT
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-4016
Mailing Address - Country:US
Mailing Address - Phone:925-876-4412
Mailing Address - Fax:
Practice Address - Street 1:610 MANHASSET CT
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-4016
Practice Address - Country:US
Practice Address - Phone:925-876-4412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist