Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | AP3476 | FL |
NPI | 1093251720 |
---|---|
Provider Name | Theresa Barcus |
First Address | Sarasota, FL 34234-7458 |
Second Address | Sarasota, FL 34236-5035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2017 |
Last Update Date | 19/01/2017 |