Healthcare Provider Details

I. General information

NPI: 1649476912
Provider Name (Legal Business Name): JACOB RYAN BARLOW D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 CENTER AVE
PITTSBURGH PA
15202-1562
US

IV. Provider business mailing address

225 CENTER AVE
PITTSBURGH PA
15202-1562
US

V. Phone/Fax

Practice location:
  • Phone: 412-734-1811
  • Fax:
Mailing address:
  • Phone: 412-734-1811
  • Fax: 412-734-1886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009634
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: