Healthcare Provider Details

I. General information

NPI: 1487852257
Provider Name (Legal Business Name): RACHEL BARLOW PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

11000 STATE ROUTE 347
EAST LIBERTY OH
43319-9470
US

IV. Provider business mailing address

3425 EXECUTIVE PKWY SUITE 128
TOLEDO OH
43606-1326
US

V. Phone/Fax

Practice location:
  • Phone: 937-645-8738
  • Fax: 937-644-7729
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA06096
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: