Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 924 | OH |
NPI | 1780920603 |
---|---|
Provider Name | Dr. Barry Joe Deal |
First Address | Tucson, AZ 85711-1215 |
Second Address | Tucson, AZ 85711-1215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2012 |
Last Update Date | 20/12/2012 |