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General NPI Number Information
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NPI Number | 1326760588
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Entity Type | Organization
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Legal Business Name | SUNSHINE THERAPY PROVIDER, PLLC
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 15870 N HAGGERTY RD
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City | PLYMOUTH
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State | MI
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Zip | 48170-4872
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Country | US
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Telephone | 248-930-1394
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Fax |
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Provider Business Mailing Address
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Address Line | 29256 RYAN RD
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City | WARREN
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State | MI
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Zip | 48092-4286
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Country | US
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Telephone | 586-751-1555
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MOHAMMED KHAN
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Credential | P.T.
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Telephone | 248-910-4801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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