Provider Demographics
NPI:1275695132
Name:BARIL, ROGER (CMT)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:
Last Name:BARIL
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 N 5TH ST STE 330
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-2684
Mailing Address - Country:US
Mailing Address - Phone:970-245-4370
Mailing Address - Fax:970-245-4370
Practice Address - Street 1:115 N 5TH ST STE 330
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2684
Practice Address - Country:US
Practice Address - Phone:970-245-4370
Practice Address - Fax:970-245-4370
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHP1013B225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist