Individual
DANIEL WOLOCKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
36475 FIVE MILE RD, LIVONIA, MI 48154-1971
(734) 655-8240
Mailing address
13245 NEWBURGH RD, LIVONIA, MI 48150-5011
(734) 655-8240
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
5501011168
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5501011168
—
MI
Enumeration date
04/03/2018
Last updated
04/03/2018
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