Provider Demographics
NPI:1093727968
Name:STARBUCK, ERIC ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ALAN
Last Name:STARBUCK
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 TYLER RD S
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-1733
Mailing Address - Country:US
Mailing Address - Phone:651-388-8113
Mailing Address - Fax:
Practice Address - Street 1:122 TYLER RD S
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-1733
Practice Address - Country:US
Practice Address - Phone:651-388-8113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4864111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN564440000Medicaid
MN564440000Medicaid