Provider Demographics
NPI:1811007990
Name:CHALIL, SUMY THOMAS (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:SUMY
Middle Name:THOMAS
Last Name:CHALIL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7285 MILLROCK AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-2381
Mailing Address - Country:US
Mailing Address - Phone:586-427-4442
Mailing Address - Fax:586-254-4042
Practice Address - Street 1:7285 MILLROCK AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-2381
Practice Address - Country:US
Practice Address - Phone:586-427-4442
Practice Address - Fax:586-254-4042
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist