Provider Demographics
NPI:1467707760
Name:GIGNAC, BARBARA ANN (PTA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:GIGNAC
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 1:2630 UNION LAKE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-3585
Mailing Address - Country:US
Mailing Address - Phone:586-566-1100
Mailing Address - Fax:
Practice Address - Street 1:2630 UNION LAKE ROAD SUITE #300
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-3435
Practice Address - Country:US
Practice Address - Phone:586-566-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility