Provider Demographics
NPI:1023580826
Name:BARNHART, THOMAS (PTA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:BARNHART
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W MAIN ST APT C
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17222-1429
Mailing Address - Country:US
Mailing Address - Phone:717-830-4488
Mailing Address - Fax:
Practice Address - Street 1:138 W MAIN ST APT C
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17222-1429
Practice Address - Country:US
Practice Address - Phone:717-830-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEO11134225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant