Nicholson, Larry E
Nicholson, Larry E is an individual health care provider with primary practice located at 1011 Parker Ave , Tracy CA 95376. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Nicholson, Larry E can be contacted via phone (209) 836-0250.Contact Information
Primary practice address
1011 Parker Ave
Tracy CA 95376
Phone: (209) 836-0250
Fax: (209) 836-5037
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Sports Physician | 111NS0005X | 17771 | California |
Profile Details
| NPI number | 1548332083 |
|---|---|
| LBN Legal business name | Nicholson, Larry E |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548332083 | NPPES |
| California | Other | DC0177710 | BLUE SHIELD |
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