Provider Demographics
NPI:1699744938
Name:BARGER, JAMES GLENN (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GLENN
Last Name:BARGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:231 BLUE RAVINE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3893
Mailing Address - Country:US
Mailing Address - Phone:916-984-9999
Mailing Address - Fax:916-351-0776
Practice Address - Street 1:231 BLUE RAVINE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3893
Practice Address - Country:US
Practice Address - Phone:916-984-9999
Practice Address - Fax:916-351-0776
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00T047720111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0123510Medicare PIN