Provider Demographics
NPI:1659944502
Name:BAROT, MAYUR
Entity Type:Individual
Prefix:
First Name:MAYUR
Middle Name:
Last Name:BAROT
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 1:10133 BOB GRAY RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-1907
Mailing Address - Country:US
Mailing Address - Phone:423-676-4050
Mailing Address - Fax:
Practice Address - Street 1:10133 BOB GRAY RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-1907
Practice Address - Country:US
Practice Address - Phone:423-676-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRCR0000000579173C00000X
TN579173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173C00000XOther Service ProvidersReflexologistGroup - Single Specialty