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Individual
JEANETTE T. BARRACK
Active
Individual
JEANETTE T. BARRACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11265
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023103330
NPI
CA
01
—
PT11265
PT LICENSE
CA
Enumeration date
05/11/2007
Last updated
09/08/2020
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