Provider Demographics
NPI:1699781757
Name:BARNETT, CHRISTOPHER GREGORY (PT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GREGORY
Last Name:BARNETT
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 1:33900 HARPER AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-416-9100
Mailing Address - Fax:586-416-9103
Practice Address - Street 1:28001 SCHOENHERR RD
Practice Address - Street 2:SUITE 6
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-4396
Practice Address - Country:US
Practice Address - Phone:586-806-6284
Practice Address - Fax:586-806-6274
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501003613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist