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General NPI Number Information
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NPI Number | 1629008206
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Entity Type | Individual
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Provider Name | DARIN NOWAK
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | 555 HIGHLAND AVE
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City | MILFORD
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State | MI
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Zip | 48381-1517
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Country | US
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Telephone | 810-966-4841
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Fax | 810-966-7927
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Provider Business Mailing Address
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Address Line | 2051 HUNTERS CREEK RD
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City | METAMORA
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State | MI
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Zip | 48455-9259
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Country | US
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Telephone | 810-571-0556
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Fax | 810-245-8576
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501009669
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License Number State | MI
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