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General NPI Number Information
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NPI Number | 1740302447
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Entity Type | Individual
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Provider Name | SUZANNE L BARRY D.O.M.
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Gender | Female
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 219 N 4TH ST
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City | BELEN
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State | NM
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Zip | 87002-4315
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Country | US
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Telephone | 505-861-0332
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Fax | 505-861-1753
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Provider Business Mailing Address
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Address Line | 219 N 4TH ST
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City | BELEN
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State | NM
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Zip | 87002-4315
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Country | US
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Telephone | 505-861-0332
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Fax | 505-861-1753
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 497
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License Number State | NM
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