Provider Demographics
NPI:1063077980
Name:SHRINER, TINA
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:SHRINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 BUCKINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2707
Mailing Address - Country:US
Mailing Address - Phone:810-210-6396
Mailing Address - Fax:
Practice Address - Street 1:1265 W HURON ST STE 101
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3677
Practice Address - Country:US
Practice Address - Phone:248-977-4594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant