Provider Demographics
NPI:1003682246
Name:STINE, SARAH (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:STINE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30200 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4502
Mailing Address - Country:US
Mailing Address - Phone:248-962-3006
Mailing Address - Fax:248-232-7328
Practice Address - Street 1:30200 TELEGRAPH RD STE 100
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4503
Practice Address - Country:US
Practice Address - Phone:248-962-3006
Practice Address - Fax:248-232-7328
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501303090225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist