Provider Demographics
NPI:1982849741
Name:ZAJAC, WENDY (PT, MSPT, OCS)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:ZAJAC
Suffix:
Gender:F
Credentials:PT, MSPT, OCS
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:HOLDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MSPT, OCS
Mailing Address - Street 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-350-2644
Mailing Address - Fax:
Practice Address - Street 1:281 ENTERPRISE CT STE 200
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0311
Practice Address - Country:US
Practice Address - Phone:248-322-5280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045514225100000X
MI5501011510225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist