Provider Demographics
NPI:1093526089
Name:BETANCOURT, BARBARA (DC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BETANCOURT
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 1:3840 PEACHTREE INDUSTRIAL BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5032
Mailing Address - Country:US
Mailing Address - Phone:770-497-9700
Mailing Address - Fax:770-497-0795
Practice Address - Street 1:3840 PEACHTREE INDUSTRIAL BLVD STE 210
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5032
Practice Address - Country:US
Practice Address - Phone:770-497-9700
Practice Address - Fax:770-497-0795
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR011310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor