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NPI 1780787929

NPI 1780787929 : ROBERT L LARSON DC : BILLINGS, MT

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General NPI Number Information
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    NPI Number           |    1780787929
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT L LARSON DC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/06/2006
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    Last Update Date     |    05/31/2013
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Provider Practice Location Address
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    Address Line         |    2147 OVERLAND AVE SUITE 101
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    City                 |    BILLINGS
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    State                |    MT
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    Zip                  |    59102-6478
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    Country              |    US
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    Telephone            |    406-655-0101
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    Fax                  |    406-655-0032
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Provider Business Mailing Address
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    Address Line         |    2147 OVERLAND AVE SUITE 101
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    City                 |    BILLINGS
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    State                |    MT
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    Zip                  |    59102-6478
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    Country              |    US
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    Telephone            |    406-655-0101
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    Fax                  |    406-655-0032
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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       |    270
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    License Number State |    MT
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