Provider Demographics
NPI:1083675417
Name:BARGE & BARGE CHIROPRACTIC CENTER LTD
Entity Type:Organization
Organization Name:BARGE & BARGE CHIROPRACTIC CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARGE
Authorized Official - Suffix:
Authorized Official - Credentials:DCC
Authorized Official - Phone:608-788-7118
Mailing Address - Street 1:2045 32ND ST S
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-7026
Mailing Address - Country:US
Mailing Address - Phone:608-788-7118
Mailing Address - Fax:608-787-6171
Practice Address - Street 1:2045 32ND ST S
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-7026
Practice Address - Country:US
Practice Address - Phone:608-788-7118
Practice Address - Fax:608-787-6171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38980000Medicaid
MN90245BAOtherBC/BS MN PROVIDER #
WI931234949017OtherBC/BS WI PROVIDER#
WI931234949017OtherBC/BS WI PROVIDER#