Individual
DR. LARRY STEVEN BALSIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4066 WHITE BEAR AVE N, WHITE BEAR LAKE, MN 55110-4305
(651) 407-0402
(651) 407-0413
Mailing address
4066 WHITE BEAR AVE N, WHITE BEAR LAKE, MN 55110-4305
(651) 407-0402
(651) 407-0413
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
#2606
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302L1BA
BLUE CROSS BLUE SHIELD
MN
Enumeration date
10/12/2006
Last updated
07/08/2007
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