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NPI Code Detail

MEDICARE: CRYSTAL BARNES OTR/L

MEDICARE: CRYSTAL BARNES OTR/L
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
1225X00000XOccupational TherapistOT004798GA

General Provider Information

NPI Number : 1912324401
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL BARNES OTR/L
Provider Business Mailing Address
First Line : 6086 WHITE PINE DR
Second Line :
City : MIDLAND
State : GA
Zip : 31820-6300
Country : US
Telephone Number : 706-662-5817
Fax Number :
Provider Business Practice Location Address
First Line : 5131 WARM SPRINGS RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-4196
Country : US
Telephone Number : 706-562-9107
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2014
Last Update Date : 03/24/2014

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