Healthcare Provider Details

I. General information

NPI: 1194160911
Provider Name (Legal Business Name): JOHN CHARLES BARR PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 03/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16615 LARK AVE SUITE101
LOS GATOS CA
95032-7645
US

IV. Provider business mailing address

16615 LARK AVE SUITE101
LOS GATOS CA
95032-7645
US

V. Phone/Fax

Practice location:
  • Phone: 140-835-8146
  • Fax: 408-358-1459
Mailing address:
  • Phone: 140-835-8146
  • Fax: 408-358-1459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT39586
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: