Healthcare Provider Details

I. General information

NPI: 1518830967
Provider Name (Legal Business Name): SPARKMAN PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6064 WEDGEWOOD DR
GRAND BLANC MI
48439-4874
US

IV. Provider business mailing address

6064 WEDGEWOOD DR
GRAND BLANC MI
48439-4874
US

V. Phone/Fax

Practice location:
  • Phone: 810-228-6780
  • Fax:
Mailing address:
  • Phone: 810-228-6780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL E SPARKMAN
Title or Position: OWNER/OPERATOR
Credential: PHYSICAL THERAPIST
Phone: 810-228-6780