Provider Demographics
NPI:1013932078
Name:BARRACK, RICK L (DC)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:L
Last Name:BARRACK
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:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92085-0039
Mailing Address - Country:US
Mailing Address - Phone:760-726-9660
Mailing Address - Fax:760-726-8865
Practice Address - Street 1:115 MAIN ST
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-6007
Practice Address - Country:US
Practice Address - Phone:760-726-9660
Practice Address - Fax:760-726-8865
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11401111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic