| Doctor Name: | MRS. DAPHNE MATILDO |
| NPI Number: | 1306902168 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 5501012453 |
| Business Practice Address: | 12855 Dix Toledo Rd Southgate, MI - 481951744 |
| Business Phone Number: | 7342832526 |
| Business Fax Number: | |
| Mailing Address: | 13200 Village Park Dr, Apt 1041 SOUTHGATE |
| State: | MI |
| Postal Code: | 481952758 |
| Phone Number: | 2197412546 |
| Fax Number: | |
| NPI Enumeration Date: | 12/28/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501012453 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |