Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC11401 | CA |
NPI | 1013932078 |
---|---|
Provider Name | Dr. Rick L. Barrack |
First Address | Vista, CA 92085-0039 |
Second Address | Vista, CA 92084-6007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 07/07/2011 |