Provider Demographics
NPI:1114370178
Name:BARRY, LISA (DC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:BARRY
Suffix:
Gender:F
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:PO BOX 9258
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-2258
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9053 ESTATE THOMAS SUITE 105
Practice Address - Street 2:ROYAL PALMS PROFESSIONAL BLDG
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-3321
Practice Address - Country:US
Practice Address - Phone:340-774-3020
Practice Address - Fax:340-774-3044
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4606111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor