Provider Demographics
NPI:1578969408
Name:BARNETT, DALYANN (ATC)
Entity Type:Individual
Prefix:
First Name:DALYANN
Middle Name:
Last Name:BARNETT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CORONADO DR
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-1149
Mailing Address - Country:US
Mailing Address - Phone:937-430-7343
Mailing Address - Fax:
Practice Address - Street 1:1400 BRUSH ROW RD
Practice Address - Street 2:MCPHERSON STADIUM - RM 100 POB 1004
Practice Address - City:WILBERFORCE
Practice Address - State:OH
Practice Address - Zip Code:45384-5800
Practice Address - Country:US
Practice Address - Phone:937-430-7343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0037012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer