Larsen, Michael L

Larsen, Michael L is an individual health care provider with primary practice located at 1052 E Losey St , Galesburg IL 61401-3874. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Larsen, Michael L can be contacted via phone (309) 342-2777.

Contact Information

Primary practice address
1052 E Losey St Galesburg IL 61401-3874
Phone: (309) 342-2777
Fax: (309) 342-6702
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038006092 Illinois

Profile Details

NPI number 1619053931
LBN Legal business name Larsen, Michael L
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2006
Last updated Jul 8th, 2007 - about 18 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 1619053931 NPPES
Illinois Other 0004882015 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 038006092 BLUE CROSS BLUE SHIELD
Illinois Other 350015512 BLUE CROSS BLUE SHIELD

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