Healthcare Provider Details

I. General information

NPI: 1801750641
Provider Name (Legal Business Name): SIDNEY CRICK PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 OLYMPUS BLVD STE 500
COPPELL TX
75019-5473
US

IV. Provider business mailing address

12083 CLOVER KNOLL RD
FENTON MI
48430-8874
US

V. Phone/Fax

Practice location:
  • Phone: 810-962-6361
  • Fax:
Mailing address:
  • Phone: 810-962-6361
  • 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: