Healthcare Provider Details

I. General information

NPI: 1124058128
Provider Name (Legal Business Name): BONNIE J O'ROURKE-BARR P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6115 ESTATE SMITH BAY APT 5 SUITE 334, 335
ST THOMAS VI
00802-1330
US

IV. Provider business mailing address

7405 ESTATE SAINT PETER
ST THOMAS VI
00802-2717
US

V. Phone/Fax

Practice location:
  • Phone: 340-513-9166
  • Fax:
Mailing address:
  • Phone: 340-513-9166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number122
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: