Individual
MR. DERRICK BARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC, ATC
Contact information
Practice address
344 WOODGREEN DR, BALLWIN, MO 63011-5031
(937) 570-7110
Mailing address
344 WOODGREEN DR, BALLWIN, MO 63011-5031
(937) 570-7110
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2023000539
MO
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
11/01/2016
Last updated
01/09/2023
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