Provider Demographics
NPI:1073832481
Name:RENFRO, BARBARA ANN (LMT, NCTMB)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANN
Last Name:RENFRO
Suffix:
Gender:F
Credentials:LMT, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6097 TERRY RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3025
Mailing Address - Country:US
Mailing Address - Phone:502-448-0429
Mailing Address - Fax:502-448-0429
Practice Address - Street 1:6097 TERRY RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3025
Practice Address - Country:US
Practice Address - Phone:502-448-0429
Practice Address - Fax:502-448-0429
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0171225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist