Provider Demographics
NPI:1376344861
Name:PATER, DAWN J (LMT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:J
Last Name:PATER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 GARFIELD RD N UNIT C
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-5167
Mailing Address - Country:US
Mailing Address - Phone:231-944-5372
Mailing Address - Fax:
Practice Address - Street 1:2301 GARFIELD RD N UNIT C
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-5167
Practice Address - Country:US
Practice Address - Phone:231-944-5372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501016633225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist