Provider Demographics
NPI:1225132939
Name:SMITH, BARRY L (DC)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:L
Last Name:SMITH
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:ELIZABETHTOWN FAMILY CHIROPRACTIC DR BARRY L SMITH
Mailing Address - Street 2:1077 DAIRY LANE
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022
Mailing Address - Country:US
Mailing Address - Phone:717-367-5777
Mailing Address - Fax:717-367-0556
Practice Address - Street 1:ELIZABETHTOWN FAMILY CHIROPRACTIC DR BARRY L SMITH
Practice Address - Street 2:1077 DAIRY LANE
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022
Practice Address - Country:US
Practice Address - Phone:717-367-5777
Practice Address - Fax:717-367-0556
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001375L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
EL362295OtherBLUE SHIELD
11235Medicare ID - Type Unspecified