MEDICARE: DR. GEORGE WILLIAM LARIVEE DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH8914	FL

General Provider Information

NPI Number	:	1467420869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE WILLIAM LARIVEE DC

Provider Business Mailing Address
First Line	:	3850 LAKE WORTH RD
Second Line	:	ST 2
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4000
Country	:	US
Telephone Number	:	561-966-1775
Fax Number	:	561-966-3934

Provider Business Practice Location Address
First Line	:	3850 LAKE WORTH RD
Second Line	:	ST 2
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4000
Country	:	US
Telephone Number	:	561-966-1775
Fax Number	:	561-966-3934

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	07/08/2007

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