Provider Demographics
NPI:1609275163
Name:REBARCAK, JAHNAYA MARCIA (BS)
Entity Type:Individual
Prefix:
First Name:JAHNAYA
Middle Name:MARCIA
Last Name:REBARCAK
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:JAHNAYA
Other - Middle Name:MARCIA
Other - Last Name:PAINCHAUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2425 ASPEN RD UNIT 102
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-4093
Mailing Address - Country:US
Mailing Address - Phone:515-233-2263
Mailing Address - Fax:515-233-5836
Practice Address - Street 1:2425 ASPEN RD UNIT 102
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-4093
Practice Address - Country:US
Practice Address - Phone:515-233-2263
Practice Address - Fax:515-233-5836
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA074841111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition