Healthcare Provider Details

I. General information

NPI: 1730152836
Provider Name (Legal Business Name): STEVEN KEITH BARRETT ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E FULTON ST
GARDEN CITY KS
67846-5455
US

IV. Provider business mailing address

105 HAMPTON CT
GARDEN CITY KS
67846-9643
US

V. Phone/Fax

Practice location:
  • Phone: 620-275-8400
  • Fax: 620-275-2687
Mailing address:
  • Phone: 620-276-8298
  • Fax: 620-275-2687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number24-00031
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: