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NPI Code Detail

MEDICARE: JAMES ERIC SENDZIK PT

MEDICARE: JAMES ERIC SENDZIK PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5501016104MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
150046054OTHERPACAPTIAL BLUE CROSS
2257173OTHERPAHEALTH AMERICA
3SE1761922OTHERPABLUE SHIELD

General Provider Information

NPI Number : 1154428464
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES ERIC SENDZIK PT
Provider Business Mailing Address
First Line : 7412 LAS PALMAS DR NE
Second Line :
City : ROCKFORD
State : MI
Zip : 49341-9581
Country : US
Telephone Number : 616-916-1347
Fax Number :
Provider Business Practice Location Address
First Line : 1900 S LACHANCE RD
Second Line :
City : LAKE CITY
State : MI
Zip : 49651-8022
Country : US
Telephone Number : 231-775-3081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 01/04/2013

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