Provider Demographics
NPI:1851618839
Name:BARRACLOUGH, DANIEL JOHN
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOHN
Last Name:BARRACLOUGH
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 1:665 ROAD RUNNER ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-0566
Mailing Address - Country:US
Mailing Address - Phone:719-574-3111
Mailing Address - Fax:719-574-2912
Practice Address - Street 1:5988 STETSON HILLS BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-3567
Practice Address - Country:US
Practice Address - Phone:719-574-3111
Practice Address - Fax:719-574-2912
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist