Healthcare Provider Details

I. General information

NPI: 1114428893
Provider Name (Legal Business Name): SPARROW HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2018
Last Update Date: 02/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E MICHIGAN AVE
LANSING MI
48912-1800
US

IV. Provider business mailing address

1200 E MICHIGAN AVE
LANSING MI
48912-1800
US

V. Phone/Fax

Practice location:
  • Phone: 517-374-5252
  • Fax:
Mailing address:
  • Phone: 517-364-5252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LETTIE J DAVENPORT
Title or Position: PHYSICAL THERAPIST ASSISTANT
Credential: AAS
Phone: 517-694-2764