MEDICARE: LARIMORE CHIROPRACTIC, PC

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	4442	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1Z5617	OTHER	AZ	HEALTHNET
2	1024511	OTHER	AZ	AMERICAN SPECIALTY HEALTH
3	1053495796	OTHER	AZ	BLUE CROSS BLUE HIELD AZ
4	623176	OTHER	AZ	AM CHIRO NETWORK
5	421915	OTHER	AZ	COVENTRY
6	2455270	OTHER	AZ	AETNA

General Provider Information

NPI Number	:	1669641072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARIMORE CHIROPRACTIC, PC

Provider Business Mailing Address
First Line	:	PO BOX 8681
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85738-0681
Country	:	US
Telephone Number	:	520-825-3103
Fax Number	:	520-825-2225

Provider Business Practice Location Address
First Line	:	3777 E GOLDER RANCH DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85739-9797
Country	:	US
Telephone Number	:	520-825-3103
Fax Number	:	520-825-2225

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. TRUDY LARIMORE WALKER
Credential	:	D.C.
Telephone Number	:	520-825-3103

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	04/23/2008

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