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NPI Code Detail

MEDICARE: DR. LARRY A BALMER D.C.

MEDICARE: DR. LARRY A BALMER D.C.
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
1111N00000XChiropractor1213MN

General Provider Information

NPI Number : 1700963766
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY A BALMER D.C.
Provider Business Mailing Address
First Line : 10404 BRIAR RD
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55437-2743
Country : US
Telephone Number : 952-884-0498
Fax Number : 952-888-7563
Provider Business Practice Location Address
First Line : 10700 NORMANDALE BLVD
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55437-2700
Country : US
Telephone Number : 952-888-5805
Fax Number : 952-888-7563
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/09/2007

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