Provider Demographics
NPI:1265470439
Name:BARBONE, JENNY J
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:J
Last Name:BARBONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 CROSSBOW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-1627
Mailing Address - Country:US
Mailing Address - Phone:803-476-3800
Mailing Address - Fax:803-476-3820
Practice Address - Street 1:257 CROSSBOW DR
Practice Address - Street 2:LEXINGTON-RICHLAND DIST 5 / GIMME FIVE
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-1627
Practice Address - Country:US
Practice Address - Phone:803-476-3800
Practice Address - Fax:803-476-3820
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30202251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics