Provider Demographics
NPI:1225552854
Name:MICHELS, SHARON DENISE (PTA)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:DENISE
Last Name:MICHELS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:DENISE
Other - Last Name:MICHELS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:1036 KING WAY
Mailing Address - Street 2:
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031-1481
Mailing Address - Country:US
Mailing Address - Phone:215-485-0660
Mailing Address - Fax:
Practice Address - Street 1:1036 KING WAY
Practice Address - Street 2:
Practice Address - City:BREINIGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18031-1481
Practice Address - Country:US
Practice Address - Phone:215-485-0660
Practice Address - Fax:215-485-0660
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI004539225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist