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General NPI Number Information
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NPI Number | 1003230467
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Entity Type | Organization
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Legal Business Name | BARTER CHIROPRACTIC
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Dates
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Enumeration Date | 02/05/2014
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 1064 WOODLAND AVE SUITE F
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City | MODESTO
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State | CA
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Zip | 95351-1542
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Country | US
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Telephone | 209-523-3720
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Fax | 209-523-3709
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Provider Business Mailing Address
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Address Line | 1064 WOODLAND AVE SUITE F
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City | MODESTO
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State | CA
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Zip | 95351-1542
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Country | US
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Telephone | 209-523-3720
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Fax | 209-523-3709
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Authorized Official
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Title or Position | SOLE PROPRIETER
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Name | DR. ERIC DEAN BARTER
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Credential | D.C.
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Telephone | 209-523-3720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC17415
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License Number State | CA
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