Provider Demographics
NPI:1326135005
Name:BARNETT, CARL (ATC, MS)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:BARNETT
Suffix:
Gender:M
Credentials:ATC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4309 COMANCHE DR
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-6971
Mailing Address - Country:US
Mailing Address - Phone:307-766-5052
Mailing Address - Fax:307-766-2112
Practice Address - Street 1:DEPT 3414 1000 E. UNIVERSITY AVE
Practice Address - Street 2:DEPARTMENT OF INTERCOL
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82071
Practice Address - Country:US
Practice Address - Phone:307-766-5052
Practice Address - Fax:307-766-2112
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer