Provider Demographics
NPI:1801889548
Name:BARTON, CORY EUGENE (ATC)
Entity type:Individual
Prefix:MR
First Name:CORY
Middle Name:EUGENE
Last Name:BARTON
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 1:5097 N SUNRIVER CIR
Mailing Address - Street 2:APT. #32
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1568
Mailing Address - Country:US
Mailing Address - Phone:520-444-7361
Mailing Address - Fax:
Practice Address - Street 1:2500 E AJO WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-6218
Practice Address - Country:US
Practice Address - Phone:520-444-7361
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ05702255A2300X
PART002200A2255A2300X
VA01260009942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer