Provider Demographics
NPI:1912144247
Name:BARNHART, ROBERT C (PT, SCDPT, PCS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:BARNHART
Suffix:
Gender:M
Credentials:PT, SCDPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70403
Mailing Address - Street 2:807 UNIVERSITY PARKWAY
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37614-1703
Mailing Address - Country:US
Mailing Address - Phone:423-439-4584
Mailing Address - Fax:423-439-4607
Practice Address - Street 1:807 UNIVERSITY PKWY
Practice Address - Street 2:ETSU CAMPUS LAMB HALL ROOM 361
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37614-6500
Practice Address - Country:US
Practice Address - Phone:423-439-4584
Practice Address - Fax:423-439-4607
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000001236225100000X
2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics