Provider Demographics
NPI:1750982443
Name:WREN, HALEY JANE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:HALEY
Middle Name:JANE
Last Name:WREN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6057 FOUNTAIN POINTE APT 12
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7794
Mailing Address - Country:US
Mailing Address - Phone:815-343-8702
Mailing Address - Fax:
Practice Address - Street 1:1085 S LINDEN RD STE 100
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3416
Practice Address - Country:US
Practice Address - Phone:810-262-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-08
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501019798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist