Provider Demographics
NPI:1760873012
Name:SIPILA, SATU-PAIVI (PT, OMT)
Entity Type:Individual
Prefix:MRS
First Name:SATU-PAIVI
Middle Name:
Last Name:SIPILA
Suffix:
Gender:F
Credentials:PT, OMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46615 MICHIGAN AVE
Mailing Address - Street 2:ORTHOSPORT
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2336
Mailing Address - Country:US
Mailing Address - Phone:734-961-9626
Mailing Address - Fax:734-961-9627
Practice Address - Street 1:46615 MICHIGAN AVE
Practice Address - Street 2:ORTHOSPORT
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-2336
Practice Address - Country:US
Practice Address - Phone:734-961-9626
Practice Address - Fax:734-961-9627
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501005420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOH29024OtherBBSM
MIP28060002Medicare UPIN