Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 000834 | CT |
NPI | 1134239718 |
---|---|
Provider Name | Dr. Robert Charles Barnett |
First Address | Gales Ferry, CT 06335-1500 |
Second Address | Gales Ferry, CT 06335-1500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |