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NPI Code Detail

MEDICARE: DR. LAWRENCE JASON LARRAGOITE DC

MEDICARE:  DR. LAWRENCE JASON LARRAGOITE  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
1111N00000XChiropractor7399AZ
2111N00000XChiropractor080802IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0939880OTHERAZBCBS
2664336OTHERAZUNITED HEALTH CARE

General Provider Information

NPI Number : 1811063456
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAWRENCE JASON LARRAGOITE DC
Provider Business Mailing Address
First Line : 4937 SHEFFIELD PL
Second Line :
City : IOWA CITY
State : IA
Zip : 52245
Country : US
Telephone Number : 623-330-1414
Fax Number :
Provider Business Practice Location Address
First Line : 4937 SHEFFIELD PL
Second Line :
City : IOWA CITY
State : IA
Zip : 52245-9242
Country : US
Telephone Number : 623-330-1414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2006
Last Update Date : 12/08/2016

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Directions to “ DR. LAWRENCE JASON LARRAGOITE DC” Practice Location

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