Healthcare Provider Details

I. General information

NPI: 1942329941
Provider Name (Legal Business Name): JESSE LEE BARRINGER PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 REGENCY MANOR CIR
COLUMBUS OH
43207-1777
US

IV. Provider business mailing address

5530 BREMEN RD SE
LANCASTER OH
43130-9419
US

V. Phone/Fax

Practice location:
  • Phone: 614-445-8261
  • Fax: 614-445-8050
Mailing address:
  • Phone: 740-536-7098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number05825
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: