Basic Information
Provider Information
NPI: 1619165255
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZAUCHA
FirstName: BARBARA
MiddleName: MCBRIDE
NamePrefix: MS.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2504 ZEPHYR CV
Address2:  
City: ROCKLIN
State: CA
PostalCode: 956774788
CountryCode: US
TelephoneNumber: 5303055557
FaxNumber:  
Practice Location
Address1: 681 BEVILLE RD
Address2:  
City: SOUTH DAYTONA
State: FL
PostalCode: 321191951
CountryCode: US
TelephoneNumber: 8003307711
FaxNumber: 8664262811
Other Information
ProviderEnumerationDate: 10/09/2007
LastUpdateDate: 10/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT 6884CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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