Provider Demographics
NPI:1083893614
Name:BARRICKLOW CHIROPRACTIC CENTER, PLLC
Entity Type:Organization
Organization Name:BARRICKLOW CHIROPRACTIC CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:LOWELL
Authorized Official - Last Name:BARRICKLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-336-7711
Mailing Address - Street 1:411 W LAKE LANSING RD.
Mailing Address - Street 2:STE A105
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8404
Mailing Address - Country:US
Mailing Address - Phone:517-336-7711
Mailing Address - Fax:517-336-7737
Practice Address - Street 1:411 W LAKE LANSING RD.
Practice Address - Street 2:STE A105
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8404
Practice Address - Country:US
Practice Address - Phone:517-336-7711
Practice Address - Fax:517-336-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005292111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3051424Medicaid