Provider Demographics
NPI:1639357890
Name:BARREDO, RONALD DE VERA (PT)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:DE VERA
Last Name:BARREDO
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 1:209 RIVERSTONE CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-2537
Mailing Address - Country:US
Mailing Address - Phone:615-889-5329
Mailing Address - Fax:615-889-5329
Practice Address - Street 1:209 RIVERSTONE CT
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2537
Practice Address - Country:US
Practice Address - Phone:615-889-5329
Practice Address - Fax:615-889-5329
Is Sole Proprietor?:No
Enumeration Date:2008-02-09
Last Update Date:2008-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2384225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics