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General NPI Number Information
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NPI Number | 1174764468
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Entity Type | Organization
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Legal Business Name | ED BARKER, D.C., LLC
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 430 LAKE HOWELL RD
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City | MAITLAND
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State | FL
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Zip | 32751-5907
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Country | US
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Telephone | 407-628-1900
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Fax | 407-628-4811
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Provider Business Mailing Address
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Address Line | 430 LAKE HOWELL RD
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City | MAITLAND
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State | FL
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Zip | 32751-5907
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Country | US
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Telephone | 407-628-1900
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Fax | 407-628-4811
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Authorized Official
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Title or Position | OWNER
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Name | DR. GLEN ED BARKER
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Credential | D.C., LLC
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Telephone | 407-628-1900
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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 | L09000021705
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License Number State | FL
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