Provider Demographics
NPI:1043387038
Name:SAKALA, CHRISTOPHER (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:SAKALA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 BAY RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2438
Mailing Address - Country:US
Mailing Address - Phone:894-015-2869
Mailing Address - Fax:
Practice Address - Street 1:314 S BROWN ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2936
Practice Address - Country:US
Practice Address - Phone:989-772-6049
Practice Address - Fax:989-772-6183
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-09-19
Deactivation Date:2019-01-17
Deactivation Code:
Reactivation Date:2019-01-30
Provider Licenses
StateLicense IDTaxonomies
MI5501006733225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0P41330Medicare ID - Type Unspecified