Basic Information
| Provider Information | |||||||||
| NPI: | 1124273735 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNES | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | COLLEEN | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 36470 25 MILE RD | ||||||||
| Address2: | |||||||||
| City: | NEW BALTIMORE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480472809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5178627317 | ||||||||
| FaxNumber: | 6163921726 | ||||||||
| Practice Location | |||||||||
| Address1: | 286 HOOVER BLVD | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494233719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6163922172 | ||||||||
| FaxNumber: | 6163921726 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2008 | ||||||||
| LastUpdateDate: | 07/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5501014133 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.