Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 5502003783 | MI |
NPI | 1013308337 |
---|---|
Provider Name | Daniel Yankee |
First Address | Clinton Township, MI 48035-4258 |
Second Address | Port Huron, MI 48060-3941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2015 |
Last Update Date | 09/02/2015 |