MEDICARE: MR. TIMOTHY M. BATT P.T.

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
1	225100000X	Physical Therapist	5501010413	MI
2	2251G0304X	Geriatric Physical Therapist	5501010413	MI

General Provider Information

NPI Number	:	1427322718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TIMOTHY M. BATT P.T.

Provider Business Mailing Address
First Line	:	2433 VALENTINE BLVD NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-3070
Country	:	US
Telephone Number	:	616-799-7891
Fax Number	:	616-863-2030

Provider Business Practice Location Address
First Line	:	2433 VALENTINE BLVD NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-3070
Country	:	US
Telephone Number	:	616-799-7891
Fax Number	:	616-863-2030

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2012
Last Update Date	:	03/15/2015

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