Provider Demographics
NPI:1902041338
Name:BARRENS, ELLIOT LAMARR
Entity Type:Individual
Prefix:MR
First Name:ELLIOT
Middle Name:LAMARR
Last Name:BARRENS
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 1:1748 W WOODROW ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-2511
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 WEST 36TH STREET NORTH
Practice Address - Street 2:CARTER HOME HEALTH
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-1700
Practice Address - Country:US
Practice Address - Phone:918-425-4000
Practice Address - Fax:918-428-0781
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT2262225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist