Healthcare Provider Details

I. General information

NPI: 1104799519
Provider Name (Legal Business Name): DAWN M VANSLEDRIGHT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6105 W ST JOE HWY STE 211
LANSING MI
48917-4850
US

IV. Provider business mailing address

6730 ADARIDGE DR SE
ADA MI
49301-9140
US

V. Phone/Fax

Practice location:
  • Phone: 888-619-9735
  • Fax:
Mailing address:
  • Phone: 616-318-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501003399
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: