Provider Demographics
NPI:1710069224
Name:PITTSFORD, BARBARA JEAN
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:PITTSFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9051 W. U. S. HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47356
Mailing Address - Country:US
Mailing Address - Phone:765-779-4505
Mailing Address - Fax:765-779-4170
Practice Address - Street 1:9051 W US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:IN
Practice Address - Zip Code:47356-9759
Practice Address - Country:US
Practice Address - Phone:765-779-4505
Practice Address - Fax:765-779-4170
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05001776A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist