Provider Demographics
NPI:1578920534
Name:BARWISE, STEPHEN GRAHAM (PT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:GRAHAM
Last Name:BARWISE
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 1:6 GARVINS FALLS RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5174
Mailing Address - Country:US
Mailing Address - Phone:603-524-3397
Mailing Address - Fax:603-524-9364
Practice Address - Street 1:6 GARVINS FALLS RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5174
Practice Address - Country:US
Practice Address - Phone:603-524-3397
Practice Address - Fax:603-524-9364
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist