Healthcare Provider Details

I. General information

NPI: 1326094293
Provider Name (Legal Business Name): LARRY ANTHONY SEARS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 12/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7410 NEW LAGRANGE RD SUITE 202
LOUISVILLE KY
40222
US

IV. Provider business mailing address

7410 NEW LAGRANGE RD SUITE 202
LOUISVILLE KY
40222
US

V. Phone/Fax

Practice location:
  • Phone: 502-425-6200
  • Fax: 502-425-6400
Mailing address:
  • Phone: 502-425-6200
  • Fax: 502-425-6400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4999
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: