Provider Demographics
NPI:1144766650
Name:REUVEN, SHONY L (DPT, PT)
Entity type:Individual
Prefix:
First Name:SHONY
Middle Name:L
Last Name:REUVEN
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9178 HIGHLAND RD STE 2
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-4619
Mailing Address - Country:US
Mailing Address - Phone:248-698-1277
Mailing Address - Fax:
Practice Address - Street 1:9178 HIGHLAND RD STE 2
Practice Address - Street 2:
Practice Address - City:WHITE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48386-4619
Practice Address - Country:US
Practice Address - Phone:248-698-1277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017921225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist