Provider Demographics
NPI:1124380449
Name:BARBY, JAI A (PT)
Entity Type:Individual
Prefix:
First Name:JAI
Middle Name:A
Last Name:BARBY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 40TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-1733
Mailing Address - Country:US
Mailing Address - Phone:580-256-2102
Mailing Address - Fax:580-256-1410
Practice Address - Street 1:1125 40TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-1733
Practice Address - Country:US
Practice Address - Phone:580-256-2102
Practice Address - Fax:580-256-1410
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4218225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist