Provider Demographics
NPI:1518083906
Name:BARRY ROAD CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:BARRY ROAD CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:EMERY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-505-1772
Mailing Address - Street 1:6316 NW BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-2531
Mailing Address - Country:US
Mailing Address - Phone:816-505-1772
Mailing Address - Fax:816-505-1599
Practice Address - Street 1:6316 NW BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-2531
Practice Address - Country:US
Practice Address - Phone:816-505-1772
Practice Address - Fax:816-505-1599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE006699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO25154022OtherBLUE CROSSBLUE SHIELD LD
MO510881822OtherTAX ID USED WITH MOST INS
MOU71134Medicare UPIN