Provider Demographics
NPI:1619040904
Name:BARNES FAMILY CHIROPRACTIC P.A.
Entity Type:Organization
Organization Name:BARNES FAMILY CHIROPRACTIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:GLYDE
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:252-754-2225
Mailing Address - Street 1:105 EASTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4216
Mailing Address - Country:US
Mailing Address - Phone:252-754-2225
Mailing Address - Fax:252-758-2251
Practice Address - Street 1:105 EASTBROOK DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4216
Practice Address - Country:US
Practice Address - Phone:252-754-2225
Practice Address - Fax:252-758-2251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3189111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1811925076OtherPERSONAL NPI