Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225200000X | Physical Therapy Assistant | 041.0101445 | VT |
Y | 225200000X | Physical Therapy Assistant | 8736 | MA |
NPI | 1013327212 |
---|---|
Provider Name | Mr. Eric Barron |
First Address | Chesterfield, NH 03443-3616 |
Second Address | Greenfield, MA 01301-9625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2014 |
Last Update Date | 28/04/2014 |