Provider Demographics
NPI:1235614215
Name:CALDER, SHERYL S (MS, PT)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:S
Last Name:CALDER
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1734 SYCAMORE CT
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1671
Mailing Address - Country:US
Mailing Address - Phone:734-709-8148
Mailing Address - Fax:734-944-1771
Practice Address - Street 1:8850 WHITTAKER RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9435
Practice Address - Country:US
Practice Address - Phone:734-709-8148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501011962OtherPHYSICAL THERAPIST LICENSE