Provider Demographics
NPI:1992311005
Name:WALPER, WENDY (MPT, BS)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:WALPER
Suffix:
Gender:F
Credentials:MPT, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N ANN ARBOR ST
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1196
Mailing Address - Country:US
Mailing Address - Phone:734-787-5295
Mailing Address - Fax:734-887-6206
Practice Address - Street 1:401 N ANN ARBOR ST
Practice Address - Street 2:STE C
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1196
Practice Address - Country:US
Practice Address - Phone:734-787-5295
Practice Address - Fax:734-887-6206
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008739225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist