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NPI Code Detail

MEDICARE: NICOLE SWEETLAND PT, DPT

MEDICARE: NICOLE SWEETLAND PT, 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
1225100000XPhysical Therapist5501304542MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15501304542OTHERMISTATE LICENSE

General Provider Information

NPI Number : 1760319214
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE SWEETLAND PT, DPT
Provider Business Mailing Address
First Line : 3073 SHIRLEY DR
Second Line :
City : JACKSON
State : MI
Zip : 49201-7010
Country : US
Telephone Number : 517-990-6210
Fax Number : 517-990-6212
Provider Business Practice Location Address
First Line : 2136 ROBINSON RD STE 1
Second Line :
City : JACKSON
State : MI
Zip : 49203-3558
Country : US
Telephone Number : 517-990-6210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2026
Last Update Date : 05/07/2026

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Directions to “ NICOLE SWEETLAND PT, DPT” Practice Location

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