Organization
BIBCO INC
Active
Other names
Back & Neck Pain Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGIL A BERRY JR. DC (OWNER)
(904) 964-8018
Entity
Organization
Contact information
Practice address
601 E CALL ST, STARKE, FL 32091
(904) 964-8018
(904) 964-9131
Mailing address
601 E CALL ST, STARKE, FL 32091
(904) 964-8018
(904) 964-9131
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH5217
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050750400
—
FL
01
—
70979
BCBS
FL
Enumeration date
10/16/2006
Last updated
06/28/2011
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