=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699982116
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA R BARRETT PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2007
-----------------------------------------------------
Last Update Date | 02/05/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 147 WASHINGTON ST
-----------------------------------------------------
City | KEENE
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03431-3131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-357-1395
-----------------------------------------------------
Fax | 603-357-1397
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 147 WASHINGTON ST
-----------------------------------------------------
City | KEENE
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03431-3131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-357-1395
-----------------------------------------------------
Fax | 603-357-1397
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 1392
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------