MEDICARE: NEILS LARSON D.C.

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	33366	CA

General Provider Information

NPI Number	:	1114393584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEILS LARSON D.C.

Provider Business Mailing Address
First Line	:	5350 HOLLISTER AVE STE A3
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93111-2326
Country	:	US
Telephone Number	:	805-681-7322
Fax Number	:	805-681-5072

Provider Business Practice Location Address
First Line	:	5350 HOLLISTER AVE STE A3
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93111-2326
Country	:	US
Telephone Number	:	805-681-7322
Fax Number	:	805-681-5072

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

Provider Enumeration Date	:	08/19/2015
Last Update Date	:	08/19/2015

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Directions to “ NEILS LARSON D.C.” Practice Location

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