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General NPI Number Information
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NPI Number | 1114663770
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Entity Type | Organization
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Legal Business Name | 100 CHIRO BARRY LLC
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 25609 SIERRA CENTER BLVD
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City | LUTZ
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State | FL
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Zip | 33559
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Country | US
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Telephone | 240-423-4996
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Fax |
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Provider Business Mailing Address
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Address Line | 25609 SIERRA CENTER BLVD
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City | LUTZ
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State | FL
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Zip | 33559-1797
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Country | US
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Telephone | 813-367-2999
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Fax | 813-367-2994
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. DARRIN MITCHELL BARRY
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Credential | DC
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Telephone | 240-423-4996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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