Provider Demographics
NPI:1467538447
Name:BARBER, GLENN EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:EDWARD
Last Name:BARBER
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 1:7171 TWO NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-7501
Mailing Address - Country:US
Mailing Address - Phone:803-699-0293
Mailing Address - Fax:803-699-5087
Practice Address - Street 1:7171 TWO NOTCH RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7501
Practice Address - Country:US
Practice Address - Phone:803-699-0293
Practice Address - Fax:803-699-5087
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC40111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor