Provider Demographics
NPI:1629317136
Name:GENOFF, DAVID M (DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:GENOFF
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:33900 HARPER AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-350-2644
Mailing Address - Fax:586-541-3735
Practice Address - Street 1:64541 VAN DYKE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:WASHINGTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48095-2570
Practice Address - Country:US
Practice Address - Phone:586-935-1100
Practice Address - Fax:586-935-1101
Is Sole Proprietor?:No
Enumeration Date:2013-02-04
Last Update Date:2023-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5501016159225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist