Provider Demographics
NPI:1851089205
Name:BARNABUS LLC
Entity Type:Organization
Organization Name:BARNABUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLEDITH
Authorized Official - Middle Name:ALFONZO
Authorized Official - Last Name:LEE
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHYSICAL THERAPY
Authorized Official - Phone:443-850-1005
Mailing Address - Street 1:10806 REISTERSTOWN RD STE 3C
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2791
Mailing Address - Country:US
Mailing Address - Phone:443-850-1005
Mailing Address - Fax:
Practice Address - Street 1:10806 REISTERSTOWN RD STE 3C
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2791
Practice Address - Country:US
Practice Address - Phone:443-850-1005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty