Individual
JEFFREY M MAIDLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2815 S PENNSYLVANIA AVE, LANSING, MI 48910-3495
(517) 975-9900
Mailing address
8614 DOE PASS, LANSING, MI 48917-8840
(517) 627-9217
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501004784
MI
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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