Healthcare Provider Details

I. General information

NPI: 1104736511
Provider Name (Legal Business Name): CHRISTINA WOLFE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2650 BENNETT RD
OKEMOS MI
48864-2464
US

IV. Provider business mailing address

3835 HEMMINGWAY DR
OKEMOS MI
48864-3836
US

V. Phone/Fax

Practice location:
  • Phone: 517-676-1051
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number5501007615
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: