Provider Demographics
NPI:1528234614
Name:BAREFOOT, ANDREA DAWN (DPT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:DAWN
Last Name:BAREFOOT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:BAREFOOT
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:640 S MURPHREY RD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-9111
Mailing Address - Country:US
Mailing Address - Phone:919-989-6594
Mailing Address - Fax:919-553-8654
Practice Address - Street 1:138 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4758
Practice Address - Country:US
Practice Address - Phone:919-989-6594
Practice Address - Fax:919-989-6532
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist