Provider Demographics
NPI:1093922999
Name:BRIGGS, CAROL JEANNE (PTA)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:JEANNE
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5138 OAKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SWARTZ CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:48473-1252
Mailing Address - Country:US
Mailing Address - Phone:810-630-2652
Mailing Address - Fax:
Practice Address - Street 1:4045 OWEN RD
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-9100
Practice Address - Country:US
Practice Address - Phone:810-750-2222
Practice Address - Fax:810-750-2978
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant