Healthcare Provider Details

I. General information

NPI: 1861977340
Provider Name (Legal Business Name): CHERYL MCCARTHY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2018
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 W ELM AVE
MONROE MI
48162-7909
US

IV. Provider business mailing address

15242 OAK KNOLL DR
MONROE MI
48161-1082
US

V. Phone/Fax

Practice location:
  • Phone: 734-241-3660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: