Provider Demographics
NPI:1689758179
Name:SELAHOWSKI, DANIEL A (PT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:A
Last Name:SELAHOWSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1350 KIRTS BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4851
Mailing Address - Country:US
Mailing Address - Phone:248-244-7927
Mailing Address - Fax:248-244-7988
Practice Address - Street 1:1350 KIRTS BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4851
Practice Address - Country:US
Practice Address - Phone:248-244-7927
Practice Address - Fax:248-244-7988
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5501001674225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist