Provider Demographics
NPI:1326071200
Name:BARRON, PATRICK S
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:S
Last Name:BARRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 S SUNNYSLOPE RD STE 103B
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-4504
Mailing Address - Country:US
Mailing Address - Phone:262-853-8452
Mailing Address - Fax:
Practice Address - Street 1:3333 S SUNNYSLOPE RD STE 103B
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-4504
Practice Address - Country:US
Practice Address - Phone:262-853-8452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9558-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist