Provider Demographics
NPI:1841387594
Name:ADOLPHSON, BARTH DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:BARTH
Middle Name:DAVID
Last Name:ADOLPHSON
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 1:3043 CENTER POINT ROAD NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-4037
Mailing Address - Country:US
Mailing Address - Phone:319-364-5000
Mailing Address - Fax:319-364-0690
Practice Address - Street 1:3043 CENTER POINT ROAD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-4037
Practice Address - Country:US
Practice Address - Phone:319-364-5000
Practice Address - Fax:319-364-0690
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIA5033111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0223933Medicaid
IA0223933Medicaid