Individual
MARTY P SHERIDAN-PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8173 CLAYTON RD, HARBOR SPRINGS, MI 49740-9571
(904) 556-4017
Mailing address
8173 CLAYTON RD, HARBOR SPRINGS, MI 49740-9571
(904) 556-4017
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502001870
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5502001870
PHYSICAL THERAPIST ASSISTANT LICENSURE
MI
Enumeration date
06/18/2013
Last updated
06/18/2013
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