Provider Demographics
NPI:1861485203
Name:BARLOW, GREGORY STEVEN (PT)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:STEVEN
Last Name:BARLOW
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E YOSEMITE AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-9100
Mailing Address - Country:US
Mailing Address - Phone:209-722-1392
Mailing Address - Fax:209-722-1393
Practice Address - Street 1:350 E YOSEMITE AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-9100
Practice Address - Country:US
Practice Address - Phone:209-722-1392
Practice Address - Fax:209-722-1393
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 20070225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT200700Medicare ID - Type Unspecified
CAP19948Medicare UPIN