MEDICARE: BARKER CHIROPRACTIC CLINIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104001258	VA
2	111N00000X	Chiropractor	0104001053	VA

General Provider Information

NPI Number	:	1821192931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARKER CHIROPRACTIC CLINIC PC

Provider Business Mailing Address
First Line	:	4903 STARKEY ROAD
Second Line	:	SUITE 100
City	:	ROANOKE
State	:	VA
Zip	:	24018
Country	:	US
Telephone Number	:	540-776-3218
Fax Number	:	540-966-7192

Provider Business Practice Location Address
First Line	:	4903 STARKEY ROAD
Second Line	:	SUITE 100
City	:	ROANOKE
State	:	VA
Zip	:	24018
Country	:	US
Telephone Number	:	540-776-3218
Fax Number	:	540-966-7192

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. JEFFREY SEAN BARKER
Credential	:	DC CCSP
Telephone Number	:	540-776-3218

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	08/22/2020

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