Individual
DEREK LARRY SHERIDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 BEARD ST, PORT HURON, MI 48060-6562
(810) 982-9500
Mailing address
28 E SANBORN AVE, CROSWELL, MI 48422-1319
(810) 300-6801
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009391
MI
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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