Provider Demographics
NPI:1972724144
Name:SALE, BARNES E III (PT)
Entity Type:Individual
Prefix:
First Name:BARNES
Middle Name:E
Last Name:SALE
Suffix:III
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 1:9826 SAN JOSE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-5438
Mailing Address - Country:US
Mailing Address - Phone:904-262-9444
Mailing Address - Fax:904-262-3750
Practice Address - Street 1:9826 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-5438
Practice Address - Country:US
Practice Address - Phone:904-262-9444
Practice Address - Fax:904-262-3750
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT0003856225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY2919ZMedicare ID - Type Unspecified