Provider Demographics
NPI:1467129155
Name:TRAN, DANNY PHUONG-HO (PTA)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:PHUONG-HO
Last Name:TRAN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1161 E CLARK RD STE 156
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-8312
Mailing Address - Country:US
Mailing Address - Phone:517-668-0000
Mailing Address - Fax:517-668-0017
Practice Address - Street 1:13575 S AIRPORT RD STE 105
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-9101
Practice Address - Country:US
Practice Address - Phone:517-668-0000
Practice Address - Fax:517-668-6676
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5502006483225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant