Provider Demographics
NPI:1326220534
Name:KNAPP, SHERYL JEAN (PTA)
Entity Type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:JEAN
Last Name:KNAPP
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:JEAN
Other - Last Name:LOOPER/COLLIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2546 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49348-9458
Mailing Address - Country:US
Mailing Address - Phone:269-397-1152
Mailing Address - Fax:
Practice Address - Street 1:1400 N DRAKE RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-1978
Practice Address - Country:US
Practice Address - Phone:269-381-0560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X
MI5502001586225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant