Individual
DR. LARRY W FULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
1313 BAPTISTE DR, PAOLA, KS 66071-1377
(913) 294-3851
(913) 294-9033
Mailing address
1313 BAPTISTE DR, PAOLA, KS 66071-1377
(913) 294-3851
(913) 294-9033
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01-03388
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000062241
BCBS OF KS PROVIDER #
KS
01
—
08800025
BCBS OF KANSAS CITY
KS
Enumeration date
05/16/2006
Last updated
09/13/2011
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