Provider Demographics
NPI:1821192931
Name:BARKER CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:BARKER CHIROPRACTIC CLINIC PC
Other - Org Name:BARKER CHIROPRACTIC SPORTS & FAMILY CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC CCSP
Authorized Official - Phone:540-776-3218
Mailing Address - Street 1:4903 STARKEY ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018
Mailing Address - Country:US
Mailing Address - Phone:540-776-3218
Mailing Address - Fax:540-966-7192
Practice Address - Street 1:4903 STARKEY ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018
Practice Address - Country:US
Practice Address - Phone:540-776-3218
Practice Address - Fax:540-966-7192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001258111N00000X
VA0104001053111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty