Provider Demographics
NPI:1184992976
Name:BARKER, JEFFREY SEAN (DC, CCSP)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SEAN
Last Name:BARKER
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 FERTIS DR.
Mailing Address - Street 2:APT. A
Mailing Address - City:WHEATLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82201
Mailing Address - Country:US
Mailing Address - Phone:970-988-7358
Mailing Address - Fax:
Practice Address - Street 1:1994 W. MARIPOSA PKWY
Practice Address - Street 2:
Practice Address - City:WHEATLAND
Practice Address - State:WY
Practice Address - Zip Code:82201
Practice Address - Country:US
Practice Address - Phone:307-331-8544
Practice Address - Fax:636-329-8977
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2024-01-24
Deactivation Date:2016-03-16
Deactivation Code:
Reactivation Date:2024-01-23
Provider Licenses
StateLicense IDTaxonomies
MO2010040257111N00000X
WY798111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor