Provider Demographics
NPI:1063616944
Name:BARLOW, DAVID R (MS, DPT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:R
Last Name:BARLOW
Suffix:
Gender:M
Credentials:MS, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 LYME RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-1219
Mailing Address - Country:US
Mailing Address - Phone:617-413-2628
Mailing Address - Fax:603-643-0022
Practice Address - Street 1:45 LYME RD
Practice Address - Street 2:SUITE 303
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1219
Practice Address - Country:US
Practice Address - Phone:802-345-8644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2009-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3211225100000X
NHNH32112251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1013798Medicaid
NH30395189Medicaid
NH000150801Medicare PIN