Provider Demographics
NPI:1588766760
Name:BARRY CHIROPRACTIC & REHABILITATION
Entity type:Organization
Organization Name:BARRY CHIROPRACTIC & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:F
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:856-435-7377
Mailing Address - Street 1:181 WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:CLEMENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-4153
Mailing Address - Country:US
Mailing Address - Phone:856-435-7377
Mailing Address - Fax:856-435-6828
Practice Address - Street 1:181 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021-4153
Practice Address - Country:US
Practice Address - Phone:856-435-7377
Practice Address - Fax:856-435-6828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC01870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2626447000OtherAMERIHEALTH
NJ1161555OtherAETNA
NJ1161555OtherAETNA
NJ2626447000OtherAMERIHEALTH