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NPI Code Detail

MEDICARE: MRS. BRENDA MARIE BARBER PTA LICENSE

MEDICARE: MRS. BRENDA MARIE BARBER PTA LICENSE
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
1225200000XPhysical Therapy Assistant1844SC
2225200000XPhysical Therapy Assistant3311NC

General Provider Information

NPI Number : 1538286497
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA MARIE BARBER PTA LICENSE
Provider Business Mailing Address
First Line : 9802 MITCHELL GLEN DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-6605
Country : US
Telephone Number : 704-287-1398
Fax Number :
Provider Business Practice Location Address
First Line : 1731 DR FRANK GASTON BLVD
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-1190
Country : US
Telephone Number : 803-329-6865
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. BRENDA MARIE BARBER PTA LICENSE” Practice Location

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