Provider Demographics
NPI:1861561862
Name:DINNER, CONSTANCE LADAY (PT, CLT)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:LADAY
Last Name:DINNER
Suffix:
Gender:F
Credentials:PT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 MAPLE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-9018
Mailing Address - Country:US
Mailing Address - Phone:231-597-9303
Mailing Address - Fax:
Practice Address - Street 1:748 SOUTH MAIN ST
Practice Address - Street 2:CHEBOYGAN MEMORIAL HOSPITAL, REHABILITATION SERVICES
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721
Practice Address - Country:US
Practice Address - Phone:231-627-1252
Practice Address - Fax:231-627-1305
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501000980225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist