Healthcare Provider Details

I. General information

NPI: 1609049188
Provider Name (Legal Business Name): CARRIE A BARRETT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2008
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 OAKLAND DR FL 3
KALAMAZOO MI
49008-1282
US

IV. Provider business mailing address

1000 OAKLAND DR FL 3
KALAMAZOO MI
49008-1282
US

V. Phone/Fax

Practice location:
  • Phone: 269-387-7000
  • Fax: 269-387-7026
Mailing address:
  • Phone: 269-387-7000
  • Fax: 269-387-7026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10953-024
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: