Provider Demographics
NPI:1750486767
Name:BARRETT, NANCY SUE (PTA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:SUE
Last Name:BARRETT
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:PO BOX 538
Mailing Address - Street 2:
Mailing Address - City:DECKERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48427-0538
Mailing Address - Country:US
Mailing Address - Phone:810-404-9927
Mailing Address - Fax:
Practice Address - Street 1:2266 MAPLE
Practice Address - Street 2:
Practice Address - City:DECKERVILLE
Practice Address - State:MI
Practice Address - Zip Code:48427-9668
Practice Address - Country:US
Practice Address - Phone:810-404-9927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant