Provider Demographics
NPI:1215258983
Name:DURHAM, BARNEY VAN II (DC)
Entity type:Individual
Prefix:DR
First Name:BARNEY
Middle Name:VAN
Last Name:DURHAM
Suffix:II
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 1:1413 KINGSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4527
Mailing Address - Country:US
Mailing Address - Phone:904-264-3966
Mailing Address - Fax:904-278-7171
Practice Address - Street 1:1413 KINGSLEY AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4527
Practice Address - Country:US
Practice Address - Phone:904-264-3966
Practice Address - Fax:904-278-7171
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9939111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor