| Doctor Name: | MRS. LAURIE GRACE STICKLER |
| NPI Number: | 1780681882 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 5501010775 |
| Business Practice Address: | 4565 Wilson Ave Sw Ste 5a Grandville, MI - 494182371 |
| Business Phone Number: | 6169759078 |
| Business Fax Number: | 6169759248 |
| Mailing Address: | 6844 Bridle Creek Ct, HUDSONVILLE |
| State: | MI |
| Postal Code: | 494269389 |
| Phone Number: | 6169759078 |
| Fax Number: | 6169759248 |
| NPI Enumeration Date: | 07/05/2005 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501010775 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |