Provider Demographics
NPI:1407992886
Name:BARNES, SHAUN M (PT)
Entity Type:Individual
Prefix:
First Name:SHAUN
Middle Name:M
Last Name:BARNES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ROBIN WAY
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-4278
Mailing Address - Country:US
Mailing Address - Phone:802-246-0169
Mailing Address - Fax:
Practice Address - Street 1:PHYSICAL THERAPY SERVICES OF BRATTLEBORO, INC.
Practice Address - Street 2:56 LINDEN STREET
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301
Practice Address - Country:US
Practice Address - Phone:802-254-4699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0003712225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist