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NPI Code Detail

MEDICARE: DR. JACOB COREY BARR DPT, MTC

MEDICARE:  DR. JACOB COREY BARR  DPT, MTC
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
1225100000XPhysical TherapistPT18544FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336100692
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACOB COREY BARR DPT, MTC
Provider Business Mailing Address
First Line : 218 LYTHAM WAY
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32124-2056
Country : US
Telephone Number : 386-299-3192
Fax Number : 386-673-3530
Provider Business Practice Location Address
First Line : 1425 HAND AVE
Second Line : SUITE H
City : ORMOND BEACH
State : FL
Zip : 32174-1135
Country : US
Telephone Number : 386-673-3535
Fax Number : 386-673-3530
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 10/09/2024

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