Provider Demographics
NPI:1679932073
Name:LAWLEY, JEFFREY JAMES (DPT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:JAMES
Last Name:LAWLEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 INKSTER RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2577
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:32500 WARREN RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-2910
Practice Address - Country:US
Practice Address - Phone:734-422-1300
Practice Address - Fax:734-422-1331
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017607225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist