Provider Demographics
NPI:1053380824
Name:BARBA, THOMAS MICHAEL (PT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:BARBA
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 1:117 E MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MI
Mailing Address - Zip Code:48611-9780
Mailing Address - Country:US
Mailing Address - Phone:989-662-7517
Mailing Address - Fax:989-662-7516
Practice Address - Street 1:117 E MIDLAND RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MI
Practice Address - Zip Code:48611-9780
Practice Address - Country:US
Practice Address - Phone:989-662-7517
Practice Address - Fax:989-662-7516
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008743225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4531595Medicaid
MI6507911090OtherBLUE CROSS
MI0995946OtherHEALTH PLUS
MI4531595Medicaid
MI6507911090OtherBLUE CROSS