Provider Demographics
NPI:1720331382
Name:BABBITT, HAYLEY (DPT)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:BABBITT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 MONROE AVE NW
Mailing Address - Street 2:SUITE 5201
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-1055
Mailing Address - Country:US
Mailing Address - Phone:616-401-2785
Mailing Address - Fax:616-328-6585
Practice Address - Street 1:1140 MONROE AVE NW
Practice Address - Street 2:SUITE 5201
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-1055
Practice Address - Country:US
Practice Address - Phone:616-401-2785
Practice Address - Fax:616-328-6585
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016033225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist