Provider Demographics
NPI:1902456973
Name:BAETZ, JUSTIN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:BAETZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4844 N ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48306-1415
Mailing Address - Country:US
Mailing Address - Phone:248-726-7015
Mailing Address - Fax:248-481-8915
Practice Address - Street 1:4844 N ADAMS RD
Practice Address - Street 2:
Practice Address - City:OAKLAND TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48306-1415
Practice Address - Country:US
Practice Address - Phone:248-726-7015
Practice Address - Fax:248-481-8915
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist