Provider Demographics
NPI:1407133051
Name:BARKER FAMILY CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:BARKER FAMILY CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:BENNETT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-314-0707
Mailing Address - Street 1:PO BOX 1662
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-1662
Mailing Address - Country:US
Mailing Address - Phone:763-314-0707
Mailing Address - Fax:763-314-0707
Practice Address - Street 1:219 W BROADWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362
Practice Address - Country:US
Practice Address - Phone:763-314-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5537261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care