Organization Name: | BARRY GORDON D.C., P.A. |
NPI Number: | 1154625978 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THAD BARRY GORDON (PRESIDENT) |
Mailing Address: | 1986 31st Ave Suite 110 Vero Beach |
State: | FL US |
Postal Code: | 329606628 |
Phone Number: | 7725673334 |
Fax Number: | 7725674523 |
NPI Enumeration Date: | 01/08/2011 |
NPI Last Update Date: | 01/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | CH2470 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |