Healthcare Provider Details

I. General information

NPI: 1720990807
Provider Name (Legal Business Name): NOAH ALAN DEHMEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 CAMPUS RIDGE DR STE 1000
MIDLAND MI
48640-6125
US

IV. Provider business mailing address

6206 FAIRWAY PINES COURT 3
BAY CITY MI
48706-9351
US

V. Phone/Fax

Practice location:
  • Phone: 989-837-9300
  • Fax:
Mailing address:
  • Phone: 810-965-0524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501304485
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: