Provider Demographics
NPI:1649497876
Name:SYSKA, MICHAEL JOSEPH JR (MPT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:SYSKA
Suffix:JR
Gender:M
Credentials:MPT
Other - Prefix:
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Mailing Address - Street 1:43740 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1122
Mailing Address - Country:US
Mailing Address - Phone:586-349-1154
Mailing Address - Fax:586-228-9019
Practice Address - Street 1:43740 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-1122
Practice Address - Country:US
Practice Address - Phone:586-349-1154
Practice Address - Fax:586-228-9019
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist