Provider Demographics
NPI:1235274432
Name:BIANCO, DANNY J
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:J
Last Name:BIANCO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49802-1109
Mailing Address - Country:US
Mailing Address - Phone:906-779-1880
Mailing Address - Fax:906-779-0818
Practice Address - Street 1:601 S WESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:KINGSFORD
Practice Address - State:MI
Practice Address - Zip Code:49802-1109
Practice Address - Country:US
Practice Address - Phone:906-779-1880
Practice Address - Fax:906-779-0818
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501003927225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B257030OtherBLUE CROSS BLUE SHIELD
MI383635119OtherTAX ID NUMBER
MI0B257030OtherBLUE CROSS BLUE SHIELD