Provider Demographics
NPI:1669542171
Name:BARNETT, KENNETH RANDALL (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:RANDALL
Last Name:BARNETT
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 1:14233 OCONNELL CT
Mailing Address - Street 2:STE 500
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2860
Mailing Address - Country:US
Mailing Address - Phone:952-226-5502
Mailing Address - Fax:952-226-5504
Practice Address - Street 1:14247 OCONNELL CT STE 275
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2880
Practice Address - Country:US
Practice Address - Phone:952-226-5502
Practice Address - Fax:952-226-5504
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor