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General NPI Number Information
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NPI Number | 1598831448
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Entity Type | Individual
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Provider Name | LARRY D LAUDENBACK DC
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Gender | Male
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 913 N 161ST E AVE SUITE E
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City | TULSA
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State | OK
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Zip | 74116
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Country | US
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Telephone | 918-672-2734
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Fax | 918-439-0222
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Provider Business Mailing Address
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Address Line | 4322 E 66TH ST SUITE 3I
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City | TULSA
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State | OK
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Zip | 74136-1667
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Country | US
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Telephone | 918-798-5500
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Fax | 918-439-0222
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3595
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License Number State | OK
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