Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 2253 | GA |
NPI | 1265866438 |
---|---|
Provider Name | Dr. Robert Wayne Barner |
First Address | Roswell, GA 30076-1482 |
Second Address | Roswell, GA 30076-1482 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2013 |
Last Update Date | 23/08/2013 |