Healthcare Provider Details

I. General information

NPI: 1235111352
Provider Name (Legal Business Name): TARAH BARRIOS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARAH L STREET PT DPT

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6438 WILMINGTON PIKE
DAYTON OH
45459-7022
US

IV. Provider business mailing address

6438 WILMINGTON PIKE
CENTERVILLE OH
45459-7022
US

V. Phone/Fax

Practice location:
  • Phone: 937-558-3810
  • Fax:
Mailing address:
  • Phone: 937-558-3810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 012569
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: