Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 005215 | CT |
NPI | 1073700985 |
---|---|
Provider Name | Mr. Douglas K. Barber |
First Address | New Britain, CT 06052-1243 |
Second Address | New Britain, CT 06052-1243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2007 |
Last Update Date | 25/09/2007 |