Provider Demographics
NPI:1659862548
Name:BARVA, LUIS
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:BARVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 PRINTERS PKWY STE 125
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-6102
Mailing Address - Country:US
Mailing Address - Phone:719-635-8622
Mailing Address - Fax:
Practice Address - Street 1:155 PRINTERS PKWY STE 125
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-6102
Practice Address - Country:US
Practice Address - Phone:719-635-8622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015585225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist