Provider Demographics
NPI:1649485004
Name:BARRICK, JOHN DAMIEN (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAMIEN
Last Name:BARRICK
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 1:72 ROUTE 236 STE 151
Mailing Address - Street 2:
Mailing Address - City:KITTERY
Mailing Address - State:ME
Mailing Address - Zip Code:03904-6512
Mailing Address - Country:US
Mailing Address - Phone:207-703-0880
Mailing Address - Fax:207-703-2530
Practice Address - Street 1:72 ROUTE 236 STE 151
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-6512
Practice Address - Country:US
Practice Address - Phone:207-703-0880
Practice Address - Fax:207-703-2530
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH280-0297111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE4413Medicare ID - Type Unspecified
NH65200Medicare UPIN