Provider Demographics
NPI:1487075669
Name:MONDAY, NICHOLAS HEIBY (DPT)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:HEIBY
Last Name:MONDAY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10483 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-9311
Mailing Address - Country:US
Mailing Address - Phone:810-771-7676
Mailing Address - Fax:810-771-7685
Practice Address - Street 1:10483 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-9311
Practice Address - Country:US
Practice Address - Phone:810-771-7676
Practice Address - Fax:810-771-7685
Is Sole Proprietor?:No
Enumeration Date:2013-12-14
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016702225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist