Provider Demographics
NPI:1528214293
Name:ANOFF, SHARON FAYE (SHARON ANOFF)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:FAYE
Last Name:ANOFF
Suffix:
Gender:F
Credentials:SHARON ANOFF
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:ANOFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SHARON ANOFF
Mailing Address - Street 1:2900 CHARLEVOIX DR SE
Mailing Address - Street 2:STE 200
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7085
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2900 CHARLEVOIX DR SE
Practice Address - Street 2:STE 2004
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7085
Practice Address - Country:US
Practice Address - Phone:800-648-8048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5014225100000X
MD19043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist