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General NPI Number Information
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NPI Number | 1730413352
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Entity Type | Individual
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Provider Name | JUSTIN BARBOUR OTR/L
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Gender | Male
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Dates
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Enumeration Date | 09/29/2009
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Last Update Date | 09/29/2009
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Provider Practice Location Address
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Address Line | 214 COCHRAN AVE
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-3875
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Country | US
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Telephone | 843-478-5625
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Fax |
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Provider Business Mailing Address
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Address Line | 728 CERTIFICATE CT
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City | CHARLESTON
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State | SC
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Zip | 29414-9117
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Country | US
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Telephone | 843-478-5625
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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 | 7313
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3443
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License Number State | SC
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