Healthcare Provider Details

I. General information

NPI: 1891608923
Provider Name (Legal Business Name): ADAM BARTA MED, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 W BANCROFT ST
TOLEDO OH
43606-3390
US

IV. Provider business mailing address

2801 W BANCROFT ST
TOLEDO OH
43606-3390
US

V. Phone/Fax

Practice location:
  • Phone: 419-530-3512
  • Fax: 419-530-6052
Mailing address:
  • Phone: 419-530-3512
  • Fax: 419-530-6052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number005085
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: