Provider Demographics
NPI:1649204488
Name:DESAI, SACHIN H (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:SACHIN
Middle Name:H
Last Name:DESAI
Suffix:
Gender:M
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 1:5034 SPRING WELL LN
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-4236
Mailing Address - Country:US
Mailing Address - Phone:810-606-0005
Mailing Address - Fax:
Practice Address - Street 1:G2037 S CENTER RD
Practice Address - Street 2:SUITE A
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48519-1101
Practice Address - Country:US
Practice Address - Phone:810-814-0607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist