Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1467000158 |
---|---|
Provider Name | Brennan Barlow |
First Address | Biloxi, MS 39532-8197 |
Second Address | Murfreesboro, TN 37129-1392 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2019 |
Last Update Date | 27/08/2019 |