Healthcare Provider Details

I. General information

NPI: 1942220348
Provider Name (Legal Business Name): SALLY J. BARNETTE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 02/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 4TH AVE
GALLIPOLIS OH
45631
US

IV. Provider business mailing address

90 JACKSON PIKE
GALLIPOLIS OH
45631-1560
US

V. Phone/Fax

Practice location:
  • Phone: 740-446-5244
  • Fax: 740-446-5448
Mailing address:
  • Phone: 740-446-5387
  • Fax: 740-446-5982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number09294
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: