Provider Demographics
NPI:1508998881
Name:BARBARO, HOLLIS MEG (PT)
Entity Type:Individual
Prefix:MRS
First Name:HOLLIS
Middle Name:MEG
Last Name:BARBARO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7744 DOAR RD
Mailing Address - Street 2:
Mailing Address - City:AWENDAW
Mailing Address - State:SC
Mailing Address - Zip Code:29429-6110
Mailing Address - Country:US
Mailing Address - Phone:843-928-4284
Mailing Address - Fax:843-856-5036
Practice Address - Street 1:1885 RIFLE RANGE RD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-9440
Practice Address - Country:US
Practice Address - Phone:843-856-4724
Practice Address - Fax:843-856-5036
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist