Healthcare Provider Details

I. General information

NPI: 1366883092
Provider Name (Legal Business Name): SHERYL LYNN HEYNIGER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 WEST UNIVERSITY DRIVE SUITE 450
ROCHESTER HILLS MI
48307
US

IV. Provider business mailing address

P.O. BOX 9042
BELFAST ME
04915
US

V. Phone/Fax

Practice location:
  • Phone: 248-650-2400
  • Fax: 248-650-4596
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number5501004543
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: