MEDICARE: BARR FAMILY CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC27198	CA

General Provider Information

NPI Number	:	1558784447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARR FAMILY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1252 AIRPORT PARK BLVD STE C5
Second Line	:
City	:	UKIAH
State	:	CA
Zip	:	95482-5979
Country	:	US
Telephone Number	:	707-462-9448
Fax Number	:	707-462-9456

Provider Business Practice Location Address
First Line	:	1252 AIRPORT PARK BLVD STE C5
Second Line	:
City	:	UKIAH
State	:	CA
Zip	:	95482-5979
Country	:	US
Telephone Number	:	707-462-9448
Fax Number	:	707-462-9456

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WALTER KENTON BARR
Credential	:	D.C.
Telephone Number	:	707-462-9448

Provider Enumeration Date	:	01/28/2014
Last Update Date	:	01/28/2014

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