Provider Demographics
NPI:1801856166
Name:BARNOWSKI, TED F (DC)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:F
Last Name:BARNOWSKI
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 1:1528 E PRIEN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8968
Mailing Address - Country:US
Mailing Address - Phone:337-479-2057
Mailing Address - Fax:337-479-2099
Practice Address - Street 1:1528 E PRIEN LAKE RD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8968
Practice Address - Country:US
Practice Address - Phone:337-479-2057
Practice Address - Fax:337-479-2099
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5X159Medicare ID - Type Unspecified