Provider Demographics
NPI:1558699561
Name:DURR, BARBARA DENISE (PTA)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:DENISE
Last Name:DURR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 BAY BLVD # 2
Mailing Address - Street 2:
Mailing Address - City:INDIAN ROCKS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33785-3834
Mailing Address - Country:US
Mailing Address - Phone:727-580-6732
Mailing Address - Fax:
Practice Address - Street 1:3141 N MCMULLEN BOOTH RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2035
Practice Address - Country:US
Practice Address - Phone:727-723-7735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP.T.A.21432225200000X
IL160.003599225200000X
FLPTA 21432225200000X
FLP.T.A. 21432225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant