Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 3211 | NH |
Y | 2251X0800X | Physical Therapist - Orthopedic | NH3211 | NH |
NPI | 1063616944 |
---|---|
Provider Name | Mr. David R Barlow |
First Address | Hanover, NH 03755-1219 |
Second Address | Hanover, NH 03755-1219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 21/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013798 | (05) | VT |
30395189 | (05) | NH |