Provider Demographics
NPI:1548536709
Name:BARBER, BRETT DYLAN (DC)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:DYLAN
Last Name:BARBER
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 1:122 PROSPECT HILL RD # C
Mailing Address - Street 2:SOFIA'S PLAZA II
Mailing Address - City:EAST WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06088-9546
Mailing Address - Country:US
Mailing Address - Phone:860-627-8868
Mailing Address - Fax:860-627-9237
Practice Address - Street 1:122 PROSPECT HILL RD # C
Practice Address - Street 2:SOFIA'S PLAZA II
Practice Address - City:EAST WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06088-9546
Practice Address - Country:US
Practice Address - Phone:860-627-8868
Practice Address - Fax:860-627-9237
Is Sole Proprietor?:No
Enumeration Date:2012-03-31
Last Update Date:2012-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001899111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor