Kristofer Daniel Larson in Wasilla - Sports Physician
Kristofer Daniel Larson - NPI 1417029976
Kristofer Daniel Larson is a Sports Physician in Wasilla, Alaska. Kristofer Daniel Larson practices all healthcare services and medical treatments related to Sports Physician. The NPI Number for Kristofer Daniel Larson is 1417029976. The last update date is 2020-12-18.
Kristofer Daniel Larson's current location address is 1001 E Bogard Rd, Wasilla, Alaska. You can contact this provider via phone number 9073762225 and fax number 9073769225. The mailing address for Kristofer Daniel Larson is 1001 E Bogard Rd, Wasilla, Alaska. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kristofer Daniel Larson |
|---|---|
| Address | 1001 E Bogard Rd, Wasilla, Alaska |
| Phone Number | 9073762225 |
| Fax Number | 9073769225 |
| Sole Proprietor | N |
| Credentials | DC |
NPI Number Detail
| NPI Number | 1417029976 |
|---|---|
| Provider Enumeration Date | 2006-11-13 |
| Last Updated Date | 2020-12-18 |
Provider Mailing Address Detail
| Address | 1001 E Bogard Rd |
|---|---|
| City | Wasilla |
| State | Alaska (AK) |
| Post Code | 99654 |
| Phone Number | 9073762225 |
| Fax Number | 9073769225 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Physician |
|---|---|
| Taxonomy | 111Ns0005X |
| Licence No | 435 |
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Definition: A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| CH0070 | AK | -- |
Post Comment/ Review Below
What is the Kristofer Daniel Larson's 1417029976?
The Kristofer Daniel Larson's NPI (National Provider Identifier) Number is 1417029976. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Kristofer Daniel Larson's facilities are situated?
The facilities of Kristofer Daniel Larson are physically located at the following address: 1001 E Bogard Rd, Wasilla, AK, 99654.
What is Kristofer Daniel Larson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kristofer Daniel Larson's area of specialization is Sports Physician, and the corresponding taxonomy code that categorizes this field of practice is 111Ns0005X.
On what date did the Kristofer Daniel Larson receive its 1417029976 assignment from the Centers for Medicare & Medicaid Services?
The Kristofer Daniel Larson was assigned its 1417029976 by the Centers for Medicare & Medicaid Services on 2006-11-13.
As of what date were the Kristofer Daniel Larson's details last updated?
The information pertaining to the Kristofer Daniel Larson, including its address, specialty, and other details, was most recently updated on 2020-12-18.
NPI Number: 1982607784
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