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General NPI Number Information
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NPI Number | 1770924326
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Entity Type | Organization
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Legal Business Name | BARTLETT CHIROPRACTIC, INC
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 07/11/2013
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Provider Practice Location Address
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Address Line | 2718 TACHEVAH DR
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City | SANTA ROSA
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State | CA
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Zip | 95405-8420
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Country | US
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Telephone | 707-579-8150
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Fax | 707-579-8161
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Provider Business Mailing Address
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Address Line | 2718 TACHEVAH DR
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City | SANTA ROSA
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State | CA
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Zip | 95405-8420
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Country | US
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Telephone | 707-579-8150
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Fax | 707-579-8161
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Authorized Official
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Title or Position | CHIROPACTOR/OWNER
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Name | DR. BRIAN A BARTLETT
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Credential | D.C.
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Telephone | 707-579-8150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DC23426
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License Number State | CA
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