Provider Demographics
NPI:1578144572
Name:KATIE M. BARGA LLC
Entity Type:Organization
Organization Name:KATIE M. BARGA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-418-9897
Mailing Address - Street 1:229 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSSIA
Mailing Address - State:OH
Mailing Address - Zip Code:45363-9631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:229 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSSIA
Practice Address - State:OH
Practice Address - Zip Code:45363-9631
Practice Address - Country:US
Practice Address - Phone:937-418-9897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy