Radke, Larry Fredric
Radke, Larry Fredric is an sole proprietor health care provider with primary practice located at 430 Sw Columbia Ave , Lake City FL 32025-5254. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Radke, Larry Fredric can be contacted via phone (386) 752-2252.Contact Information
Primary practice address
430 Sw Columbia Ave
Lake City FL 32025-5254
Phone: (386) 752-2252
Fax: (386) 754-5088
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | CH0002067 | Florida |
Profile Details
| NPI number | 1649481052 |
|---|---|
| LBN Legal business name | Radke, Larry Fredric |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 25th, 2007 |
| 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 | 1649481052 | NPPES |
| Florida | Other | 89714 | BLUECROSS BLUESHIELD PROV |
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