Healthcare Provider Details

I. General information

NPI: 1538208822
Provider Name (Legal Business Name): JOHN ANDREW BARRETT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8177 NITTANY VALLEY DRIVE
MILL HALL PA
17751-8802
US

IV. Provider business mailing address

8177 NITTANY VALLEY DRIVE
MILL HALL PA
17751-8802
US

V. Phone/Fax

Practice location:
  • Phone: 570-726-4911
  • Fax: 570-726-4911
Mailing address:
  • Phone: 570-726-4911
  • Fax: 570-726-4911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC005455L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: