Provider Demographics
NPI:1598164584
Name:BARRETT, CHANTEL (CMT)
Entity Type:Individual
Prefix:
First Name:CHANTEL
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6040 MAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROCKFORD
Mailing Address - State:MN
Mailing Address - Zip Code:55373-9501
Mailing Address - Country:US
Mailing Address - Phone:612-356-0173
Mailing Address - Fax:763-477-6228
Practice Address - Street 1:8340 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MN
Practice Address - Zip Code:55373-9578
Practice Address - Country:US
Practice Address - Phone:612-356-0173
Practice Address - Fax:763-477-6228
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist