Provider Demographics
NPI: | 1356362537 |
---|---|
Name: | LENOX, BARRI BRITTAIN (PT) |
Entity type: | Individual |
Prefix: | |
First Name: | BARRI |
Middle Name: | BRITTAIN |
Last Name: | LENOX |
Suffix: | |
Gender: | F |
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: | 251 JOHNSTON ST SE |
Mailing Address - Street 2: | STE 200 |
Mailing Address - City: | DECATUR |
Mailing Address - State: | AL |
Mailing Address - Zip Code: | 35601-2515 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 256-350-1764 |
Mailing Address - Fax: | 256-350-8995 |
Practice Address - Street 1: | 2506 DANVILLE RD SW |
Practice Address - Street 2: | SUITE 200 |
Practice Address - City: | DECATUR |
Practice Address - State: | AL |
Practice Address - Zip Code: | 35603-4232 |
Practice Address - Country: | US |
Practice Address - Phone: | 256-350-6331 |
Practice Address - Fax: | 256-350-1990 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-22 |
Last Update Date: | 2018-08-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AL | PTH631 | 225100000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AL | DB9027 | Other | RAILROAD MEDICARE GROUP |
AL | 529917620 | Medicaid | |
AL | K531 | Other | MEDICARE GROUP PIN |
AL | 1003819608 | Other | GROUP NPI |