Provider Demographics
NPI:1518928951
Name:BARNES, STEPHEN FRANK (PTA)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:FRANK
Last Name:BARNES
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10320 MALLARD CRK RD
Mailing Address - Street 2:SUITE 275
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262
Mailing Address - Country:US
Mailing Address - Phone:704-549-9322
Mailing Address - Fax:704-549-9460
Practice Address - Street 1:10320 MALLARD CRK RD
Practice Address - Street 2:SUITE 275
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262
Practice Address - Country:US
Practice Address - Phone:704-549-9322
Practice Address - Fax:704-549-9460
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2855225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant