MEDICARE: MR. JAMES BARBER A.T.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	25MT00029800	NJ

General Provider Information

NPI Number	:	1275782799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES BARBER A.T.C.

Provider Business Mailing Address
First Line	:	2204 MIDDLE AVE
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-5135
Country	:	US
Telephone Number	:	732-714-5387
Fax Number	:

Provider Business Practice Location Address
First Line	:	346 CHAMBERSBRIDGE RD
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08723-2804
Country	:	US
Telephone Number	:	732-262-2500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2008
Last Update Date	:	09/09/2008

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