Healthcare Provider Details

I. General information

NPI: 1659417814
Provider Name (Legal Business Name): KEITH BARRETT PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 HILL RD N
PICKERINGTON OH
43147-8984
US

IV. Provider business mailing address

70 S CLEVELAND AVE
WESTERVILLE OH
43081-1397
US

V. Phone/Fax

Practice location:
  • Phone: 614-890-6555
  • Fax: 614-818-7750
Mailing address:
  • Phone: 614-890-6555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT9233
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: