Provider Demographics
NPI:1366803371
Name:DAVEY, JAIME (DPT)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:DAVEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50200 DENNIS CT
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-2021
Mailing Address - Country:US
Mailing Address - Phone:248-229-5000
Mailing Address - Fax:
Practice Address - Street 1:33566 W 8 MILE RD
Practice Address - Street 2:SUITE A
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48335-5271
Practice Address - Country:US
Practice Address - Phone:248-478-7330
Practice Address - Fax:248-478-4352
Is Sole Proprietor?:No
Enumeration Date:2016-03-18
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist