Healthcare Provider Details

I. General information

NPI: 1811022577
Provider Name (Legal Business Name): THOMAS W. BARTLETT D.C. PROF.CORP. A CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 POSADA LN SUITE A
TEMPLETON CA
93465-4058
US

IV. Provider business mailing address

935 SALIDA DEL SOL
PASO ROBLES CA
93446
US

V. Phone/Fax

Practice location:
  • Phone: 805-434-5080
  • Fax: 805-434-5081
Mailing address:
  • Phone: 805-238-1013
  • Fax: 805-238-6999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number17385
License Number StateCA

VIII. Authorized Official

Name: DR. THOMAS WILLIAM BARTLETT
Title or Position: PRESIDENT
Credential: D.C.
Phone: 805-434-5080