Provider Demographics
NPI:1316384050
Name:BARNARD, LAUREN A (PTA)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:BARNARD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 MCINTOSH DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-1633
Mailing Address - Country:US
Mailing Address - Phone:937-672-2550
Mailing Address - Fax:
Practice Address - Street 1:3024 MCINTOSH DR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-1633
Practice Address - Country:US
Practice Address - Phone:937-672-2550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013137225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0013137OtherMEDICARE