Provider Demographics
NPI:1265170781
Name:BARRY, PAUL (ATC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:BARRY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 BILTMORE AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-1765
Mailing Address - Country:US
Mailing Address - Phone:401-529-9381
Mailing Address - Fax:
Practice Address - Street 1:47 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-1765
Practice Address - Country:US
Practice Address - Phone:401-529-9381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer