Healthcare Provider Details

I. General information

NPI: 1013106590
Provider Name (Legal Business Name): DANIELLE-NOELLE D. WUERFEL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11095 W COLLINA VISTA DR
STAR ID
83669-6339
US

IV. Provider business mailing address

2101 N CARDIGAN AVE
STAR ID
83669-6124
US

V. Phone/Fax

Practice location:
  • Phone: 269-277-1224
  • Fax:
Mailing address:
  • Phone: 269-277-1224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7278
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: