Provider Demographics
NPI:1720440159
Name:SHERRY, KALI ALYSS (PT,DPT, KEOMPT)
Entity type:Individual
Prefix:MRS
First Name:KALI
Middle Name:ALYSS
Last Name:SHERRY
Suffix:
Gender:
Credentials:PT,DPT, KEOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21922 ABERDEEN DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-3860
Mailing Address - Country:US
Mailing Address - Phone:586-222-3009
Mailing Address - Fax:
Practice Address - Street 1:72980 FULTON ST STE B
Practice Address - Street 2:
Practice Address - City:ARMADA
Practice Address - State:MI
Practice Address - Zip Code:48005-4873
Practice Address - Country:US
Practice Address - Phone:586-784-6004
Practice Address - Fax:586-784-6009
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT41449225100000X
MI5501017594225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist