Provider Demographics
NPI:1356559538
Name:O'NEILL, BARBARA W (PT)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:W
Last Name:O'NEILL
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 1:25 TECOLOTE RD
Mailing Address - Street 2:
Mailing Address - City:TIJERAS
Mailing Address - State:NM
Mailing Address - Zip Code:87059-7446
Mailing Address - Country:US
Mailing Address - Phone:505-286-9024
Mailing Address - Fax:505-286-9033
Practice Address - Street 1:25 TECOLOTE RD
Practice Address - Street 2:
Practice Address - City:TIJERAS
Practice Address - State:NM
Practice Address - Zip Code:87059-7446
Practice Address - Country:US
Practice Address - Phone:505-286-9024
Practice Address - Fax:505-286-9033
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM986225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist