Provider Demographics
NPI:1194794883
Name:OOLE, SHARI ELLEN (ATC)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:ELLEN
Last Name:OOLE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 SILVER LAKE RD
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:MI
Mailing Address - Zip Code:48451-8710
Mailing Address - Country:US
Mailing Address - Phone:810-591-0423
Mailing Address - Fax:810-591-8116
Practice Address - Street 1:3240 W SILVER LAKE RD
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-1374
Practice Address - Country:US
Practice Address - Phone:810-714-4616
Practice Address - Fax:810-714-4809
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26010000592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer