Larson, Kristofer Daniel

Larson, Kristofer Daniel is an individual health care provider with primary practice located at 1001 E Bogard Rd , Wasilla AK 99654. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Larson, Kristofer Daniel can be contacted via phone (907) 376-2225.

Contact Information

Primary practice address
1001 E Bogard Rd Wasilla AK 99654
Phone: (907) 376-2225
Fax: (907) 376-9225
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 435 Alaska

Profile Details

NPI number 1417029976
LBN Legal business name Larson, Kristofer Daniel
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Dec 18th, 2020 - about 4 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 1417029976 NPPES
Alaska MEDICAID CH0070

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