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NPI Code Detail

MEDICARE: JEFFREY RAYMOND BAREFOOT PTA

MEDICARE: JEFFREY RAYMOND BAREFOOT PTA
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
1225200000XPhysical Therapy Assistant7697MA

General Provider Information

NPI Number : 1932300282
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY RAYMOND BAREFOOT PTA
Provider Business Mailing Address
First Line : 25 FORGE RD
Second Line :
City : ASSONET
State : MA
Zip : 02702-1428
Country : US
Telephone Number : 781-585-4100
Fax Number :
Provider Business Practice Location Address
First Line : 17 CHIPMAN WAY
Second Line :
City : KINGSTON
State : MA
Zip : 02364-1039
Country : US
Telephone Number : 781-585-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2007
Last Update Date : 07/08/2007

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