Provider Demographics
NPI:1205341815
Name:BARNHART, MITCHELL (ATC)
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:
Last Name:BARNHART
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2064 N RED CLIFF
Mailing Address - Street 2:SANCTUARY BOX B #3
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-2636
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3901 E STANFORD DR
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-7536
Practice Address - Country:US
Practice Address - Phone:602-955-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2022-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZATR-008952OtherARIZONA BOARD OF ATHLETIC TRAINING
AZATR-008952OtherARIZONA BOARD OF ATHLETIC TRAINING
694320OtherACSM