Healthcare Provider Details

I. General information

NPI: 1033482468
Provider Name (Legal Business Name): DANIEL M HALFMAN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 01/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 N ANKENY BLVD STE. 101
ANKENY IA
50023-4714
US

IV. Provider business mailing address

625 ENTERPRISE DR
OAK BROOK IL
60523-8813
US

V. Phone/Fax

Practice location:
  • Phone: 515-965-4594
  • Fax: 515-965-4448
Mailing address:
  • Phone: 630-575-1980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2012004491
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number086073
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: