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General NPI Number Information
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NPI Number | 1427706555
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Entity Type | Individual
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Provider Name | JACK BARKER
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Gender | Male
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 67 MOUNTAINBROOK RD
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City | ASHEVILLE
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State | NC
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Zip | 28805-1238
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Country | US
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Telephone | 304-677-1758
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Fax |
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Provider Business Mailing Address
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Address Line | 11 BROADMOOR DR
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City | ARDEN
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State | NC
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Zip | 28704-0600
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Country | US
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Telephone | 304-677-1758
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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