Provider Demographics
NPI:1487754248
Name:BARGER CHIROPRACTIC
Entity type:Organization
Organization Name:BARGER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:BARGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:336-992-1111
Mailing Address - Street 1:806B PLAZA 66 HWY 66 S
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284
Mailing Address - Country:US
Mailing Address - Phone:336-992-1111
Mailing Address - Fax:336-992-1111
Practice Address - Street 1:806B PLAZA 66 HWY 66 S
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284
Practice Address - Country:US
Practice Address - Phone:336-992-1111
Practice Address - Fax:336-992-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2236111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890823XMedicaid
NC890823XMedicaid
NCU58179Medicare UPIN