Provider Demographics
NPI:1881952257
Name:BAJEMA, CHRISTOPHER MARSHALL (PT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MARSHALL
Last Name:BAJEMA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:350 LAFAYETTE AVE SE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4656
Mailing Address - Country:US
Mailing Address - Phone:616-456-8515
Mailing Address - Fax:616-233-1118
Practice Address - Street 1:350 LAFAYETTE AVE SE
Practice Address - Street 2:SUITE 500
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4656
Practice Address - Country:US
Practice Address - Phone:616-456-8515
Practice Address - Fax:616-233-1118
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010035382251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic