Healthcare Provider Details

I. General information

NPI: 1841570223
Provider Name (Legal Business Name): BRIAN MICHAEL BARIT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 06/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 HOWARD AVE SUITE A
MULLENS WV
25882-1421
US

IV. Provider business mailing address

614 CLUB CIR
DANIELS WV
25832-9216
US

V. Phone/Fax

Practice location:
  • Phone: 770-402-1208
  • Fax:
Mailing address:
  • Phone: 770-402-1208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number918
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: