Healthcare Provider Details

I. General information

NPI: 1861485203
Provider Name (Legal Business Name): GREGORY STEVEN BARLOW PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 E YOSEMITE AVE
MERCED CA
95340-9100
US

IV. Provider business mailing address

350 E YOSEMITE AVE
MERCED CA
95340-9100
US

V. Phone/Fax

Practice location:
  • Phone: 209-722-1392
  • Fax: 209-722-1393
Mailing address:
  • Phone: 209-722-1392
  • Fax: 209-722-1393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 20070
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: