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General NPI Number Information
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NPI Number | 1932336096
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Entity Type | Organization
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Legal Business Name | LARRY E MASULA CHIROPRACTIC OFFICE INC
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 06/16/2009
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Provider Practice Location Address
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Address Line | 30 PHILADELPHIA DR STE A
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City | CHICO
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State | CA
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Zip | 95973-4932
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Country | US
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Telephone | 530-342-6441
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Fax | 530-342-5441
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Provider Business Mailing Address
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Address Line | 30 PHILADELPHIA DR STE A
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City | CHICO
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State | CA
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Zip | 95973-4932
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Country | US
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Telephone | 530-342-6441
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Fax | 530-342-5441
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Authorized Official
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Title or Position | PRESIDENT
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Name | LARRY ERNEST MASULA
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Credential | DC
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Telephone | 530-342-6441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | DC11770
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License Number State | CA
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