Provider Demographics
NPI:1124058128
Name:O'ROURKE-BARR, BONNIE J (PT)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:J
Last Name:O'ROURKE-BARR
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 1:7405 ESTATE SAINT PETER
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-2717
Mailing Address - Country:US
Mailing Address - Phone:340-513-9166
Mailing Address - Fax:
Practice Address - Street 1:6115 ESTATE SMITH BAY APT 5
Practice Address - Street 2:SUITE 334, 335
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-1330
Practice Address - Country:US
Practice Address - Phone:340-513-9166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist