| NPI | 1679320741 |
|---|---|
| Former Name | DOUGLAS BARNES |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305216629) |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-08-28 |