Healthcare Provider Details

I. General information

NPI: 1528340486
Provider Name (Legal Business Name): JENNIFER M WELSMAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER M DRAKE

II. Dates (important events)

Enumeration Date: 09/15/2011
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5678 SASHABAW RD
CLARKSTON MI
48346-3148
US

IV. Provider business mailing address

33900 HARPER AVE STE 104
CLINTON TWP MI
48035-4258
US

V. Phone/Fax

Practice location:
  • Phone: 248-922-9280
  • Fax: 248-922-9287
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501016367
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: