Provider Demographics
NPI:1184720526
Name:BARR, DAVID C (DC, CCST)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:BARR
Suffix:
Gender:M
Credentials:DC, CCST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 N STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-2225
Mailing Address - Country:US
Mailing Address - Phone:715-848-2526
Mailing Address - Fax:
Practice Address - Street 1:1404 N STEVENS ST
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-2225
Practice Address - Country:US
Practice Address - Phone:715-362-6505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3079-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38877000Medicaid
WICJ7409OtherRAILROAD MEDICARE GROUP
WI39926OtherSECURITY HEALTH PLAN
WI39926OtherSECURITY HEALTH PLAN
WI000170480Medicare ID - Type Unspecified
U47588Medicare UPIN