Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT13794 | FL |
NPI | 1194121301 |
---|---|
Provider Name | Robert Barnhard |
First Address | Ponte Vedra Beach, FL 32082-2646 |
Second Address | Ponte Vedra Beach, FL 32082-2646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2014 |
Last Update Date | 16/11/2014 |