MEDICARE: MARTINE BARRE 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	6072	SC
2	208100000X	Physical Medicine & Rehabilitation Physician	2305208770	VA

General Provider Information

NPI Number	:	1306114715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTINE BARRE DPT

Provider Business Mailing Address
First Line	:	6420 SEMINOLE TRL
Second Line	:	L4
City	:	BARBOURSVILLE
State	:	VA
Zip	:	22923-2836
Country	:	US
Telephone Number	:	434-939-9524
Fax Number	:	434-939-9679

Provider Business Practice Location Address
First Line	:	6420 SEMINOLE TRL
Second Line	:	L4
City	:	BARBOURSVILLE
State	:	VA
Zip	:	22923-2836
Country	:	US
Telephone Number	:	434-939-9524
Fax Number	:	434-939-9679

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

Provider Enumeration Date	:	12/13/2011
Last Update Date	:	03/11/2021

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Directions to “ MARTINE BARRE DPT” Practice Location

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