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NPI Code Detail

MEDICARE: KRISTIN BRATTON MPT

MEDICARE: KRISTIN BRATTON MPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist55010210504MI

General Provider Information

NPI Number : 1174563506
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN BRATTON MPT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18101 E WARREN AVE
Second Line :
City : DETROIT
State : MI
Zip : 48224-1382
Country : US
Telephone Number : 313-881-5678
Fax Number : 313-881-9337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 11/25/2014

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Directions to “ KRISTIN BRATTON MPT” Practice Location

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