Provider Demographics
NPI:1275386476
Name:BARCLAY, KRYSTAL (DC)
Entity Type:Individual
Prefix:DR
First Name:KRYSTAL
Middle Name:
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 E CAMPANELLA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-5122
Mailing Address - Country:US
Mailing Address - Phone:803-543-1693
Mailing Address - Fax:
Practice Address - Street 1:150 HIGHLAND CENTER DR STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-9247
Practice Address - Country:US
Practice Address - Phone:803-543-1693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor