Provider Demographics
NPI:1356416804
Name:STURMAN, MICHELLE J (PT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:J
Last Name:STURMAN
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 1:345 SANTA FE DR
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5132
Mailing Address - Country:US
Mailing Address - Phone:760-753-0703
Mailing Address - Fax:760-753-0272
Practice Address - Street 1:345 SANTA FE DR
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5132
Practice Address - Country:US
Practice Address - Phone:760-753-0703
Practice Address - Fax:760-753-0272
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 21760225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT21760AMedicare ID - Type Unspecified