Basic Information
| Provider Information | |||||||||
| NPI: | 1225307739 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARSH | ||||||||
| FirstName: | IRENE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PHYSICAL THERAPIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 325 W CENTER ST APT 231 | ||||||||
| Address2: | |||||||||
| City: | OREM | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840574688 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014264905 | ||||||||
| FaxNumber: | 8014264953 | ||||||||
| Practice Location | |||||||||
| Address1: | 5314 RIVER RUN DR STE 140 | ||||||||
| Address2: | |||||||||
| City: | PROVO | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846045691 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014264905 | ||||||||
| FaxNumber: | 8014264953 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2011 | ||||||||
| LastUpdateDate: | 12/29/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1131952401 | UT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.