Provider Demographics
NPI:1578007167
Name:BARNETT, LUTHER VAL (PT)
Entity Type:Individual
Prefix:
First Name:LUTHER
Middle Name:VAL
Last Name:BARNETT
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 1:118 SUMMERTON DR
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-4806
Mailing Address - Country:US
Mailing Address - Phone:440-668-7463
Mailing Address - Fax:814-226-1240
Practice Address - Street 1:118 SUMMERTON DR
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4806
Practice Address - Country:US
Practice Address - Phone:440-668-7463
Practice Address - Fax:814-226-1240
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002958L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist