Provider Demographics
NPI:1255470712
Name:BARR, KEVIN (MAC, LAC)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:BARR
Suffix:
Gender:M
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 STANBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:PA
Mailing Address - Zip Code:19070-1330
Mailing Address - Country:US
Mailing Address - Phone:610-585-5800
Mailing Address - Fax:
Practice Address - Street 1:100 PARK AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-1727
Practice Address - Country:US
Practice Address - Phone:610-585-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000556L171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist