Provider Demographics
NPI:1821124785
Name:BARNEY, BRENT M (DC)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:M
Last Name:BARNEY
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 1:1213 AUBURN DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-3221
Mailing Address - Country:US
Mailing Address - Phone:719-471-1733
Mailing Address - Fax:
Practice Address - Street 1:1213 AUBURN DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3221
Practice Address - Country:US
Practice Address - Phone:719-471-1733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2464111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO536628Medicare ID - Type Unspecified
COU40579Medicare UPIN