Provider Demographics
NPI:1538587068
Name:THARRETT, STEVEN (PT)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:THARRETT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1916
Mailing Address - Country:US
Mailing Address - Phone:248-673-6980
Mailing Address - Fax:248-673-7497
Practice Address - Street 1:5225 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1916
Practice Address - Country:US
Practice Address - Phone:248-673-6980
Practice Address - Fax:248-673-7497
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016670225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist