Provider Demographics
NPI:1194999292
Name:KLEIN, BARRY PHILIP (DC)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:PHILIP
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 N PALM AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3229
Mailing Address - Country:US
Mailing Address - Phone:954-443-2420
Mailing Address - Fax:954-443-6661
Practice Address - Street 1:1561 N PALM AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3229
Practice Address - Country:US
Practice Address - Phone:954-443-2420
Practice Address - Fax:954-443-6661
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55902OtherBLUE CROSS BLUE SHIELD