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NPI Code Detail

MEDICARE: SIDNEY CRICK PT, DPT

MEDICARE: SIDNEY CRICK 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 Therapist

General Provider Information

NPI Number : 1801750641
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIDNEY CRICK PT, DPT
Provider Business Mailing Address
First Line : 12083 CLOVER KNOLL RD
Second Line :
City : FENTON
State : MI
Zip : 48430-8874
Country : US
Telephone Number : 810-962-6361
Fax Number :
Provider Business Practice Location Address
First Line : 3100 OLYMPUS BLVD STE 500
Second Line :
City : COPPELL
State : TX
Zip : 75019-5473
Country : US
Telephone Number : 810-962-6361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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