Provider Demographics
NPI:1114663770
Name:100 CHIRO BARRY LLC
Entity Type:Organization
Organization Name:100 CHIRO BARRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:240-423-4996
Mailing Address - Street 1:25609 SIERRA CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-1797
Mailing Address - Country:US
Mailing Address - Phone:813-367-2999
Mailing Address - Fax:813-367-2994
Practice Address - Street 1:25609 SIERRA CENTER BLVD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559
Practice Address - Country:US
Practice Address - Phone:240-423-4996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty