Provider Demographics
NPI:1174829477
Name:BARRY, MAUREEN LOUISE (DC)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:LOUISE
Last Name:BARRY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MAUREEN
Other - Middle Name:LOUISE
Other - Last Name:MOIR-BARRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1059 S US HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879-2437
Mailing Address - Country:US
Mailing Address - Phone:989-224-8688
Mailing Address - Fax:989-224-7886
Practice Address - Street 1:1059 S US HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-2437
Practice Address - Country:US
Practice Address - Phone:989-224-8688
Practice Address - Fax:989-224-7886
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009674111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor