Provider Demographics
NPI:1003017625
Name:BARROW, JANNELLE SOLANGE (PT)
Entity type:Individual
Prefix:MS
First Name:JANNELLE
Middle Name:SOLANGE
Last Name:BARROW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14645 KEENELAND CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3772
Mailing Address - Country:US
Mailing Address - Phone:240-683-3909
Mailing Address - Fax:
Practice Address - Street 1:301 RUSSELL AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2805
Practice Address - Country:US
Practice Address - Phone:301-216-4247
Practice Address - Fax:301-216-4249
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20599225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist