Provider Demographics
NPI:1831748227
Name:SROKA, MORGAN (DPT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:SROKA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:JANES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-416-9100
Mailing Address - Fax:
Practice Address - Street 1:30100 TELEGRAPH RD STE 140
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4516
Practice Address - Country:US
Practice Address - Phone:248-385-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501019127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist