MEDICARE: LARRY DOUGLAS GUINN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	632	OH
2	111N00000X	Chiropractor	2961	MI
3	111N00000X	Chiropractor	5111	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043211253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY DOUGLAS GUINN DC

Provider Business Mailing Address
First Line	:	2477 SHORELAND AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43611-1567
Country	:	US
Telephone Number	:	419-729-1619
Fax Number	:	419-729-1675

Provider Business Practice Location Address
First Line	:	2477 SHORELAND AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43611-1567
Country	:	US
Telephone Number	:	419-729-1619
Fax Number	:	419-729-1675

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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Directions to “ LARRY DOUGLAS GUINN DC” Practice Location

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