Individual
MRS. DAPHNE MATILDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
12855 DIX TOLEDO RD, SOUTHGATE, MI 48195-1744
(734) 283-2526
Mailing address
13200 VILLAGE PARK DR, APT 1041, SOUTHGATE, MI 48195-2758
(219) 741-2546
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012453
MI
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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