Individual
MICHAEL JOHN DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1065 W BROADWAY AVE, MEDFORD, WI 54451-1311
(715) 748-2316
(715) 748-2570
Mailing address
1065 W BROADWAY AVE, MEDFORD, WI 54451-1311
(715) 748-2316
(715) 748-2570
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9578-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40397600
—
WI
Enumeration date
12/17/2007
Last updated
12/17/2007
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