Formanek, Larry M

Formanek, Larry M is an individual health care provider with primary practice located at 115 E Main St , Knoxville IA 50138-2525. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Formanek, Larry M can be contacted via phone (641) 842-3007.

Contact Information

Primary practice address
115 E Main St Knoxville IA 50138-2525
Phone: (641) 842-3007
Fax: (641) 842-5612
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X AO5434 Iowa

Profile Details

NPI number 1558350546
LBN Legal business name Formanek, Larry M
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated May 29th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558350546 NPPES
Iowa MEDICAID 0285262
Iowa Other 6599

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