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Individual

MR. COLM TYLER BARRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
5930 ADOBE RD, TWENTYNINE PALMS, CA 92277-2356
(760) 367-1743
Mailing address
138 EDGEWATER DR, EDGEWATER, MD 21037-1324
(443) 949-5509

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
49845
CA
225200000X
Physical Therapy Assistant
A3958
MD

Other

Enumeration date
09/13/2023
Last updated
09/13/2023
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