Provider Demographics
NPI:1851694012
Name:BARRY, DONALD ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ARTHUR
Last Name:BARRY
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 1:23050 SKYLINK DR
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92587-8951
Mailing Address - Country:US
Mailing Address - Phone:951-415-9033
Mailing Address - Fax:
Practice Address - Street 1:26900 NEWPORT RD STE 110
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-9224
Practice Address - Country:US
Practice Address - Phone:951-672-8060
Practice Address - Fax:951-672-7490
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2021-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8123653-1202111N00000X
CADC22582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor