Provider Demographics
NPI:1457695645
Name:BARKER, CORY PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:PATRICK
Last Name:BARKER
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 1:18910 JOSEPH DR
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95949-7211
Mailing Address - Country:US
Mailing Address - Phone:530-913-5784
Mailing Address - Fax:
Practice Address - Street 1:845 TWELVE BRIDGES DR STE 140
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-8819
Practice Address - Country:US
Practice Address - Phone:916-209-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC32411111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor