Provider Demographics
NPI:1194484154
Name:BARNHART, KELLI (PTA)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:BARNHART
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:101 PINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:OH
Mailing Address - Zip Code:43107-1136
Mailing Address - Country:US
Mailing Address - Phone:740-475-9674
Mailing Address - Fax:
Practice Address - Street 1:957 BECKS KNOB RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8800
Practice Address - Country:US
Practice Address - Phone:740-653-9481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH005104225200000X
183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant