Provider Demographics
NPI:1942280417
Name:REBARCAK, DAVID K (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:REBARCAK
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 1:1129 6TH ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201-1827
Mailing Address - Country:US
Mailing Address - Phone:515-382-2225
Mailing Address - Fax:515-382-5430
Practice Address - Street 1:1129 6TH ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:IA
Practice Address - Zip Code:50201-1827
Practice Address - Country:US
Practice Address - Phone:515-382-2225
Practice Address - Fax:515-382-5430
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05185111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0258004Medicaid
IAT02015Medicare UPIN
IA11731Medicare ID - Type Unspecified