Healthcare Provider Details

I. General information

NPI: 1740119700
Provider Name (Legal Business Name): RACHAEL DIANE SWEIGARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51220 VAN DYKE AVE
SHELBY TOWNSHIP MI
48316-4440
US

IV. Provider business mailing address

55217 HAYES RD
SHELBY TOWNSHIP MI
48315-6614
US

V. Phone/Fax

Practice location:
  • Phone: 586-800-4364
  • Fax:
Mailing address:
  • Phone: 248-231-9705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501304571
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: