Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | TEI005534 | PA |
NPI | 1013528215 |
---|---|
Provider Name | Mr. Dennis Anthony Barker JR. |
First Address | Philadelphia, PA 19125-3114 |
Second Address | Philadelphia, PA 19125-3114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2020 |
Last Update Date | 11/08/2020 |