Provider Demographics
NPI:1992074546
Name:BARNES, THOMAS X IV (MPT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:X
Last Name:BARNES
Suffix:IV
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 W MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1454
Mailing Address - Country:US
Mailing Address - Phone:330-702-0110
Mailing Address - Fax:330-702-0510
Practice Address - Street 1:498 LISBON RD
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:PA
Practice Address - Zip Code:16115-3309
Practice Address - Country:US
Practice Address - Phone:724-495-6139
Practice Address - Fax:724-643-2121
Is Sole Proprietor?:No
Enumeration Date:2011-12-27
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT014305225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist