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General NPI Number Information
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NPI Number | 1992035349
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Entity Type | Organization
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Legal Business Name | ROBERT LARSON, DC PC
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Dates
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Enumeration Date | 01/07/2010
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 2147 OVERLAND AVE STE 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 STE 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 | OWNER/PROVIDER
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Name | DR. ROBERT LEROY LARSON
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Credential | DC
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Telephone | 406-655-0101
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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 | C 270
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License Number State | MT
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