Healthcare Provider Details

I. General information

NPI: 1053215855
Provider Name (Legal Business Name): ANDREA BINIECKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 TRAUTNER DR STE 202
SAGINAW MI
48604-8201
US

IV. Provider business mailing address

2205 TRAUTNER DR STE 202
SAGINAW MI
48604-8201
US

V. Phone/Fax

Practice location:
  • Phone: 989-860-1425
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number5502009069
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: