Provider Demographics
NPI:1932464260
Name:STANLEY, BARRETT GENE (DPT)
Entity Type:Individual
Prefix:
First Name:BARRETT
Middle Name:GENE
Last Name:STANLEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:3640 MUNDY MILL RD
Practice Address - Street 2:STE 102B
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-8218
Practice Address - Country:US
Practice Address - Phone:770-287-8821
Practice Address - Fax:770-287-8797
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010716225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist