Provider Demographics
NPI:1356463608
Name:BARTLETT, DONNA M (DC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DONNA
Other - Middle Name:MICHELE
Other - Last Name:MASS BARTLETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:2299 EAST MAIN STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-5513
Mailing Address - Country:US
Mailing Address - Phone:805-648-6277
Mailing Address - Fax:
Practice Address - Street 1:2299 EAST MAIN STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-5513
Practice Address - Country:US
Practice Address - Phone:805-648-6277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 17381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor