Provider Demographics
NPI:1972167336
Name:BARKER, DANIEL JAMES (DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:BARKER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 THOMASTON RD
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:CT
Mailing Address - Zip Code:06763-1916
Mailing Address - Country:US
Mailing Address - Phone:910-489-7232
Mailing Address - Fax:
Practice Address - Street 1:611 E HILL RD # 745-2295
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-1388
Practice Address - Country:US
Practice Address - Phone:203-745-2295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11947225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty