Provider Demographics
NPI:1992725022
Name:BARFKNECHT, JON (ATC)
Entity type:Individual
Prefix:MR
First Name:JON
Middle Name:
Last Name:BARFKNECHT
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3806 GRANT LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-6752
Mailing Address - Country:US
Mailing Address - Phone:573-489-5506
Mailing Address - Fax:573-875-7415
Practice Address - Street 1:1001 ROGERS ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65216-0001
Practice Address - Country:US
Practice Address - Phone:573-875-7407
Practice Address - Fax:573-875-7415
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1076412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer