MEDICARE: MS. CHERYL LYNN SHEETS LPTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	160.004188	IL

General Provider Information

NPI Number	:	1316270820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHERYL LYNN SHEETS LPTA

Provider Business Mailing Address
First Line	:	5940 NEUMAN RD
Second Line	:
City	:	SAINT CLAIR
State	:	MI
Zip	:	48079-3221
Country	:	US
Telephone Number	:	810-531-5169
Fax Number	:

Provider Business Practice Location Address
First Line	:	5940 NEUMAN RD
Second Line	:
City	:	SAINT CLAIR
State	:	MI
Zip	:	48079-3221
Country	:	US
Telephone Number	:	810-531-5169
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2009
Last Update Date	:	09/15/2009

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