Healthcare Provider Details

I. General information

NPI: 1063410330
Provider Name (Legal Business Name): WENDY BARNES P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 08/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 EDWARDS ST
WESTCLIFFE CO
81252-8588
US

IV. Provider business mailing address

PO BOX 120
WESTCLIFFE CO
81252-0120
US

V. Phone/Fax

Practice location:
  • Phone: 719-783-2380
  • Fax: 719-783-2377
Mailing address:
  • Phone: 719-783-2380
  • Fax: 719-783-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7205
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: