MEDICARE: MRS. GENEVIEVE BARRETT PT

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	07200R	LA

General Provider Information

NPI Number	:	1770685786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GENEVIEVE BARRETT PT

Provider Business Mailing Address
First Line	:	2820 HEARNE AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71103-3934
Country	:	US
Telephone Number	:	318-631-7999
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 HOSPITAL DR STE 120
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-2168
Country	:	US
Telephone Number	:	318-747-1760
Fax Number	:

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	02/11/2008

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