Provider Demographics
NPI:1013327212
Name:BARRON, ERIC (PTA)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:BARRON
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 STAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03443-3616
Mailing Address - Country:US
Mailing Address - Phone:603-363-4446
Mailing Address - Fax:
Practice Address - Street 1:130 COLRAIN RD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-9625
Practice Address - Country:US
Practice Address - Phone:413-774-3724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8736225200000X
VT041.0101445225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant