Provider Demographics
NPI:1033223383
Name:ISLES-TRUAX, SHEILA A (PT,FAAOMPT)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:A
Last Name:ISLES-TRUAX
Suffix:
Gender:F
Credentials:PT,FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 N SAGINAW RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-7501
Mailing Address - Country:US
Mailing Address - Phone:989-832-6485
Mailing Address - Fax:989-832-6485
Practice Address - Street 1:5319 N SAGINAW RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-7501
Practice Address - Country:US
Practice Address - Phone:989-832-6485
Practice Address - Fax:989-832-6485
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004287261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M79680Medicare PIN