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General NPI Number Information
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NPI Number | 1942748603
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Entity Type | Organization
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Legal Business Name | DOWNTOWN CHIROPRACTIC
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 325 E WASHINGTON ST SUITE 101
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City | IOWA CITY
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State | IA
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Zip | 52240-3968
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Country | US
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Telephone | 319-383-8290
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Fax |
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Provider Business Mailing Address
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Address Line | 325 E WASHINGTON ST SUITE 101
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City | IOWA CITY
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State | IA
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Zip | 52240-3968
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Country | US
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Telephone | 319-383-8290
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. LAWRENCE J LARRAGOITE
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Credential | DC
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Telephone | 319-383-8290
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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 | 080802
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License Number State | IA
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