Provider Demographics
NPI:1063625523
Name:BARTLETT, BETSY J (DC)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:J
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E. MAIN STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757
Mailing Address - Country:US
Mailing Address - Phone:304-822-3425
Mailing Address - Fax:304-822-7096
Practice Address - Street 1:500 E.MAIN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757
Practice Address - Country:US
Practice Address - Phone:304-822-3425
Practice Address - Fax:304-822-7096
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV350039200Medicare ID - Type Unspecified