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General NPI Number Information
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NPI Number | 1639559487
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Entity Type | Individual
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Provider Name | DANIEL THOMAS GAFFNEY PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 06/08/2015
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 4351 24TH AVE
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City | FORT GRATIOT
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State | MI
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Zip | 48059-4506
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Country | US
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Telephone | 810-384-7405
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Fax | 810-385-7420
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Provider Business Mailing Address
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Address Line | 4351 24TH AVE
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City | FORT GRATIOT
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State | MI
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Zip | 48059-4506
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Country | US
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Telephone | 810-384-7405
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Fax | 810-385-7420
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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 | 5501017214
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License Number State | MI
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