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General NPI Number Information
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NPI Number | 1285840751
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Entity Type | Individual
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Provider Name | SHARON BARABARA ANGELINE PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15979 HALL ROAD SUITE 150
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City | MACOMB TOWNSHIP
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State | MI
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Zip | 48044
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Country | US
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Telephone | 586-416-8430
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Fax | 586-416-8440
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Provider Business Mailing Address
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Address Line | 1655 MAPLE CREEK CT
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City | ROCHESTER
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State | MI
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Zip | 48306-4812
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Country | US
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Telephone | 248-650-0973
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Fax | 586-416-8440
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501001612
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License Number State | MI
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