MEDICARE: KATIA MARIE SKARUPINSKI DPT

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
1	225100000X	Physical Therapist	5501302625	MI

General Provider Information

NPI Number	:	1558135426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIA MARIE SKARUPINSKI DPT

Provider Business Mailing Address
First Line	:	7226 S SULLIVAN RD
Second Line	:
City	:	CEDAR
State	:	MI
Zip	:	49621-8698
Country	:	US
Telephone Number	:	231-835-0999
Fax Number	:

Provider Business Practice Location Address
First Line	:	5536 RESEARCH DR
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48188-2261
Country	:	US
Telephone Number	:	734-895-1901
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	11/13/2023

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