Provider Demographics
NPI:1760098065
Name:BARNES, CALEB (DPT)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:BARNES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 N REDBUD AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67147-3229
Mailing Address - Country:US
Mailing Address - Phone:316-516-7154
Mailing Address - Fax:
Practice Address - Street 1:901 LAKEPOINT DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:KS
Practice Address - Zip Code:67010-2423
Practice Address - Country:US
Practice Address - Phone:316-775-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06601225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist