MEDICARE: LARSON CHIROPRACTIC WELLNESS CENTER

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

General Provider Information

NPI Number	:	1891671038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARSON CHIROPRACTIC WELLNESS CENTER

Provider Business Mailing Address
First Line	:	1027 LAKE OCONEE PKWY STE 700
Second Line	:
City	:	EATONTON
State	:	GA
Zip	:	31024-5586
Country	:	US
Telephone Number	:	706-749-2067
Fax Number	:	706-749-2068

Provider Business Practice Location Address
First Line	:	1027 LAKE OCONEE PKWY STE 700
Second Line	:
City	:	EATONTON
State	:	GA
Zip	:	31024-5586
Country	:	US
Telephone Number	:	706-749-2067
Fax Number	:	706-749-2068

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ERIC LARSON
Credential	:	DC
Telephone Number	:	706-749-2067

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	08/13/2025

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