Provider Demographics
NPI:1710372438
Name:BARTON, NICOLE JOCENE (ATC, SCAT)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:JOCENE
Last Name:BARTON
Suffix:
Gender:F
Credentials:ATC, SCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 SOUTHERN DR
Mailing Address - Street 2:APT 1901
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-5189
Mailing Address - Country:US
Mailing Address - Phone:503-881-1274
Mailing Address - Fax:803-509-6390
Practice Address - Street 1:1051 SOUTHERN DR
Practice Address - Street 2:APT 1901
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-5189
Practice Address - Country:US
Practice Address - Phone:503-881-1274
Practice Address - Fax:803-509-6390
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14732255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer