Provider Demographics
NPI:1992863989
Name:BARCEWSKI, MARK RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:RYAN
Last Name:BARCEWSKI
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 1:13982 WEST BOWLES AVENUE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-1444
Mailing Address - Country:US
Mailing Address - Phone:303-932-2225
Mailing Address - Fax:720-922-7761
Practice Address - Street 1:13982 W BOWLES AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-1444
Practice Address - Country:US
Practice Address - Phone:303-932-2225
Practice Address - Fax:720-922-7761
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5249111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO5249OtherLICENSE
CO805094Medicare ID - Type Unspecified
COU90060Medicare UPIN