Provider Demographics
NPI:1194160911
Name:BARR, JOHN CHARLES (PT, DPT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:BARR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16615 LARK AVE
Mailing Address - Street 2:SUITE101
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-7645
Mailing Address - Country:US
Mailing Address - Phone:140-835-8146
Mailing Address - Fax:408-358-1459
Practice Address - Street 1:16615 LARK AVE
Practice Address - Street 2:SUITE101
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-7645
Practice Address - Country:US
Practice Address - Phone:140-835-8146
Practice Address - Fax:408-358-1459
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT39586225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist