MEDICARE: DR. LARRY K CIMPERMAN 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
1	111N00000X	Chiropractor	DC003463L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	513500	OTHER	PA	HIGHMARK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750362281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY K CIMPERMAN D.C.

Provider Business Mailing Address
First Line	:	890 PITTSBURGH RD
Second Line	:	SUITE 2
City	:	BUTLER
State	:	PA
Zip	:	16002-8958
Country	:	US
Telephone Number	:	724-586-9777
Fax Number	:

Provider Business Practice Location Address
First Line	:	890 PITTSBURGH ROAD
Second Line	:	SUITE 2
City	:	BUTLER
State	:	PA
Zip	:	16002-8958
Country	:	US
Telephone Number	:	724-586-9777
Fax Number	:

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	07/08/2007

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