Provider Demographics
NPI:1043556376
Name:DEMSKE, SHARON (PTA)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:DEMSKE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27240 HAGGERTY RD
Mailing Address - Street 2:STE E-15
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-5716
Mailing Address - Country:US
Mailing Address - Phone:886-991-0900
Mailing Address - Fax:866-992-0900
Practice Address - Street 1:27240 HAGGERTY RD
Practice Address - Street 2:STE E-15
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-5716
Practice Address - Country:US
Practice Address - Phone:866-991-0900
Practice Address - Fax:866-992-0900
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502000540225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant