Provider Demographics
NPI:1245538701
Name:BARK CHIROPRACTIC AND REHAB CLINIC, LLC
Entity type:Organization
Organization Name:BARK CHIROPRACTIC AND REHAB CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-263-3800
Mailing Address - Street 1:228 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-3738
Mailing Address - Country:US
Mailing Address - Phone:563-263-3800
Mailing Address - Fax:563-263-3801
Practice Address - Street 1:228 W 2ND ST
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-3738
Practice Address - Country:US
Practice Address - Phone:563-263-3800
Practice Address - Fax:563-263-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty