Provider Demographics
NPI:1215227863
Name:BARBER, ROBERT (LMT, CKTP, CHHC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:BARBER
Suffix:
Gender:M
Credentials:LMT, CKTP, CHHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 PEARL ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2438
Mailing Address - Country:US
Mailing Address - Phone:720-428-8563
Mailing Address - Fax:
Practice Address - Street 1:3000 PEARL ST
Practice Address - Street 2:SUITE 207
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2438
Practice Address - Country:US
Practice Address - Phone:720-428-8563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-17
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10473225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist