Provider Demographics
NPI:1699000174
Name:SONI, VIKAS R (RPT)
Entity Type:Individual
Prefix:MR
First Name:VIKAS
Middle Name:R
Last Name:SONI
Suffix:
Gender:M
Credentials:RPT
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Mailing Address - Street 1:5511 W US HIGHWAY 10
Mailing Address - Street 2:SUITE # B
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-2455
Mailing Address - Country:US
Mailing Address - Phone:231-845-0900
Mailing Address - Fax:231-845-0909
Practice Address - Street 1:5710 BELLA ROSA BLVD
Practice Address - Street 2:SUITE # 300
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48348-4773
Practice Address - Country:US
Practice Address - Phone:248-922-3339
Practice Address - Fax:248-922-3337
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5501014832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501014832OtherSTATE OF MICHIGAN