Provider Demographics
NPI:1346360898
Name:BARRETTE, KIM STEVEN (MS, PT)
Entity type:Individual
Prefix:MR
First Name:KIM
Middle Name:STEVEN
Last Name:BARRETTE
Suffix:
Gender:M
Credentials:MS, PT
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Mailing Address - Street 1:602 WELLS ST
Mailing Address - Street 2:
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-1304
Mailing Address - Country:US
Mailing Address - Phone:715-735-9388
Mailing Address - Fax:715-735-9398
Practice Address - Street 1:602 WELLS ST
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-1304
Practice Address - Country:US
Practice Address - Phone:715-735-9388
Practice Address - Fax:715-735-9398
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI1758-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist