Basic Information
| Provider Information | |||||||||
| NPI: | 1164468575 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VOLTZ | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Credential: | DPT, ATC, CSCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 GARDEN OF EDEN RD | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198031511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024771536 | ||||||||
| FaxNumber: | 3024771564 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 GARDEN OF EDEN RD | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198031511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024771536 | ||||||||
| FaxNumber: | 3024771564 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 11/03/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | J10002073 | DE | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.