Provider Demographics
NPI:1922862689
Name:BARMORE, MADISON
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:BARMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 HEARTLAND ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:IA
Mailing Address - Zip Code:52228-9645
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 HEARTLAND ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:IA
Practice Address - Zip Code:52228-9645
Practice Address - Country:US
Practice Address - Phone:319-432-8126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA122973111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor