Provider Demographics
NPI:1033767256
Name:CHMIELEWSKI, DEANNA (DPT)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:CHMIELEWSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:WIESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-416-9100
Mailing Address - Fax:
Practice Address - Street 1:8917 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-6955
Practice Address - Country:US
Practice Address - Phone:407-822-7506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT38967208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation