Provider Demographics
NPI:1972139327
Name:DAVIS, BARBARA JANE (PT/DPT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JANE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT/DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 MERLE HAY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-1357
Mailing Address - Country:US
Mailing Address - Phone:515-278-8444
Mailing Address - Fax:515-278-6723
Practice Address - Street 1:4020 MERLE HAY RD STE 200
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-1357
Practice Address - Country:US
Practice Address - Phone:515-278-8444
Practice Address - Fax:515-278-6723
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02366225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist