Provider Demographics
NPI:1790823052
Name:KERI BITHER-BARNES, DC, DACNB, A CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:KERI BITHER-BARNES, DC, DACNB, A CHIROPRACTIC CORPORATION
Other - Org Name:SHASTA FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPLE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:KERI
Authorized Official - Middle Name:M
Authorized Official - Last Name:BITHER-BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACNB
Authorized Official - Phone:530-365-4595
Mailing Address - Street 1:2976 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:CA
Mailing Address - Zip Code:96007-3367
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2976 W CENTER ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:CA
Practice Address - Zip Code:96007-3367
Practice Address - Country:US
Practice Address - Phone:530-365-4595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28038111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV06464Medicare UPIN