Provider Demographics
NPI:1346762812
Name:WORKMAN, SALLY ANN
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:ANN
Last Name:WORKMAN
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 1:1310 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-4930
Mailing Address - Country:US
Mailing Address - Phone:231-598-2356
Mailing Address - Fax:123-796-4271
Practice Address - Street 1:650 LINDEN ST STE 2
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-1880
Practice Address - Country:US
Practice Address - Phone:231-598-2356
Practice Address - Fax:231-796-4271
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI12195171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist