MEDICARE: DR. LARRY LEE LIBS 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	111NX0800X	Orthopedic Chiropractor	2301005437	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	38-2837719	OTHER	MI	COMMERCIAL INSURANCE
2	950D611170	OTHER	MI	BCBSM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710900519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY LEE LIBS DC

Provider Business Mailing Address
First Line	:	3228 N 109TH PL
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-8908
Country	:	US
Telephone Number	:	517-270-2704
Fax Number	:	517-270-2704

Provider Business Practice Location Address
First Line	:	3228 N 109TH PL
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66109
Country	:	US
Telephone Number	:	517-263-6181
Fax Number	:	517-263-6181

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	03/21/2017

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Directions to “ DR. LARRY LEE LIBS DC” Practice Location

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