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NPI Code Detail

MEDICARE: ALYSHA P DAVIS-BARTH DPT

MEDICARE: ALYSHA P DAVIS-BARTH 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
1208100000XPhysical Medicine & Rehabilitation Physician070013030IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1070013030OTHERILSTATE LICENSE

General Provider Information

NPI Number : 1740212455
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSHA P DAVIS-BARTH DPT
Provider Business Mailing Address
First Line : 1089 JASON PL
Second Line :
City : CHATHAM
State : IL
Zip : 62629-2018
Country : US
Telephone Number : 217-483-5858
Fax Number : 217-483-5855
Provider Business Practice Location Address
First Line : 1089 JASON PL
Second Line :
City : CHATHAM
State : IL
Zip : 62629-2018
Country : US
Telephone Number : 217-483-5858
Fax Number : 217-483-5855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 04/17/2009

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Directions to “ ALYSHA P DAVIS-BARTH DPT” Practice Location

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