Provider Demographics
NPI:1295831451
Name:BARE, PRESTON K (DC)
Entity Type:Individual
Prefix:DR
First Name:PRESTON
Middle Name:K
Last Name:BARE
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 1:3773 S PINE AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-6608
Mailing Address - Country:US
Mailing Address - Phone:352-369-6325
Mailing Address - Fax:352-369-6329
Practice Address - Street 1:3773 S PINE AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6608
Practice Address - Country:US
Practice Address - Phone:352-369-6325
Practice Address - Fax:352-369-6329
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9163111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor