Provider Demographics
NPI:1518002575
Name:SAMUEL H BARKER DC PC
Entity type:Organization
Organization Name:SAMUEL H BARKER DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-734-0000
Mailing Address - Street 1:844 WASHINGTON ST N
Mailing Address - Street 2:STE 400
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3874
Mailing Address - Country:US
Mailing Address - Phone:208-734-0000
Mailing Address - Fax:208-735-5053
Practice Address - Street 1:844 WASHINGTON ST N
Practice Address - Street 2:STE 400
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3874
Practice Address - Country:US
Practice Address - Phone:208-734-0000
Practice Address - Fax:208-735-5053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA1210111N00000X
IDCHIA-1210111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty