Provider Demographics
NPI:1093291155
Name:SABHLOK, SHEETAL
Entity Type:Individual
Prefix:
First Name:SHEETAL
Middle Name:
Last Name:SABHLOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 CHICAGO RD STE D
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-5033
Mailing Address - Country:US
Mailing Address - Phone:586-978-9850
Mailing Address - Fax:
Practice Address - Street 1:5701 CHICAGO RD STE D
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-5033
Practice Address - Country:US
Practice Address - Phone:586-978-9850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist