Provider Demographics
NPI:1477548824
Name:BARKLEY, COLLEEN (MPT, SCS, ATC)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:
Last Name:BARKLEY
Suffix:
Gender:F
Credentials:MPT, SCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:SC
Mailing Address - Zip Code:29061-9174
Mailing Address - Country:US
Mailing Address - Phone:803-776-1038
Mailing Address - Fax:
Practice Address - Street 1:4500 STUART ST
Practice Address - Street 2:PHYSICAL THERAPY CLINIC
Practice Address - City:FORT JACKSON
Practice Address - State:SC
Practice Address - Zip Code:29207-5700
Practice Address - Country:US
Practice Address - Phone:803-751-3021
Practice Address - Fax:803-751-0518
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20262251S0007X
SC4462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer