MEDICARE: DARA BARNETT IRVING PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PTH5574	AL

General Provider Information

NPI Number	:	1255730792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARA BARNETT IRVING PT, DPT

Provider Business Mailing Address
First Line	:	6397 LEE HWY STE 300
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-4915
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:	423-238-3473

Provider Business Practice Location Address
First Line	:	2703 LEGENDS PKWY
Second Line	:
City	:	PRATTVILLE
State	:	AL
Zip	:	36066-7755
Country	:	US
Telephone Number	:	334-380-4930
Fax Number	:	334-380-4931

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2014
Last Update Date	:	03/04/2019

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