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General NPI Number Information
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NPI Number | 1801990957
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Entity Type | Individual
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Provider Name | LARRY D MCILROY DC
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Gender | Male
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 111 JOHN DUPREE DR
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City | LEVELLAND
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State | TX
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Zip | 79336
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Country | US
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Telephone | 806-894-8119
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Fax | 806-894-2796
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Provider Business Mailing Address
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Address Line | PO BOX 459
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City | LEVELLAND
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State | TX
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Zip | 79336-0459
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Country | US
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Telephone | 806-894-8119
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Fax | 806-894-2796
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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 | 5763 DC
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License Number State | TX
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