Provider Demographics
NPI:1124287172
Name:BARRETT CHIROPRACTIC PA
Entity type:Organization
Organization Name:BARRETT CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-745-2258
Mailing Address - Street 1:30332 OVERSEAS HWY
Mailing Address - Street 2:
Mailing Address - City:BIG PINE KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33043-3352
Mailing Address - Country:US
Mailing Address - Phone:305-872-2258
Mailing Address - Fax:305-515-0245
Practice Address - Street 1:30332 OVERSEAS HWY
Practice Address - Street 2:
Practice Address - City:BIG PINE KEY
Practice Address - State:FL
Practice Address - Zip Code:33043-3352
Practice Address - Country:US
Practice Address - Phone:305-872-2258
Practice Address - Fax:305-515-0245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6115111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT88189Medicare UPIN