Provider Demographics
NPI:1487611323
Name:BARNES, DENISE D (PT)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:D
Last Name:BARNES
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:PO BOX 1776
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-1776
Mailing Address - Country:US
Mailing Address - Phone:573-348-4004
Mailing Address - Fax:573-348-3272
Practice Address - Street 1:1191 HIGHWAY KK
Practice Address - Street 2:SUITE 102
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065-3344
Practice Address - Country:US
Practice Address - Phone:573-348-4004
Practice Address - Fax:573-348-3272
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist