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Organization
PASADENA NECK AND BACK PAIN CENTER LLC
Active
Organization
PASADENA NECK AND BACK PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND K BARRY DC (OWNER)
(410) 360-0014
Entity
Organization
Contact information
Practice address
8096 EDWIN RAYNOR BLVD STE A, PASADENA, MD 21122-6837
(410) 360-0014
(410) 360-0064
Mailing address
8096 EDWIN RAYNOR BLVD STE A, PASADENA, MD 21122-6837
(410) 360-0014
(410) 360-0064
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S01558
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2184080
AETNA
MD
01
—
353259
MAMSI
MD
01
—
629389
ACN
MD
01
—
KE24PA
BCBS MD
MD
01
—
T773
BCBS OF DC
DC
Enumeration date
08/26/2005
Last updated
04/25/2012
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