Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 2026 | SC |
NPI | 1477548824 |
---|---|
Provider Name | Mrs. Colleen Barkley |
First Address | Hopkins, SC 29061-9174 |
Second Address | Fort Jackson, SC 29207-5700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 08/07/2007 |