Provider Demographics
NPI:1114191210
Name:BARRETT, SAMUEL E (DC)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:E
Last Name:BARRETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13607 STATE ROUTE 422
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-3549
Mailing Address - Country:US
Mailing Address - Phone:724-543-1199
Mailing Address - Fax:
Practice Address - Street 1:13607 STATE ROUTE 422
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-3549
Practice Address - Country:US
Practice Address - Phone:724-543-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor