Provider Demographics
NPI:1942252663
Name:NORLIN, SANDRA DIANE (PT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:DIANE
Last Name:NORLIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 PLEASANT VALLEY
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48380-2618
Mailing Address - Country:US
Mailing Address - Phone:248-684-2080
Mailing Address - Fax:
Practice Address - Street 1:7743 GRAND RIVER RD
Practice Address - Street 2:#100
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7393
Practice Address - Country:US
Practice Address - Phone:810-227-3588
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501001382225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist