Healthcare Provider Details

I. General information

NPI: 1386917136
Provider Name (Legal Business Name): STEPHANIE LOUISE PALMATEER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPHANIE L DAGGETT DPT

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23211 21 MILE RD
MACOMB MI
48042-5184
US

IV. Provider business mailing address

878 S ROCHESTER RD
ROCHESTER HILLS MI
48307-2767
US

V. Phone/Fax

Practice location:
  • Phone: 586-231-0043
  • Fax: 586-741-8953
Mailing address:
  • Phone: 248-601-9207
  • Fax: 248-650-8670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501015824
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: