Individual
SHARAUN WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6525 2ND AVE, DETROIT, MI 48202-3006
(313) 972-4140
Mailing address
6525 2ND AVE, DETROIT, MI 48202-3006
(313) 972-4140
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
5501019267
MI
Other
Enumeration date
03/18/2021
Last updated
03/23/2021
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