Individual
MR. LARRY CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, CNMT
Contact information
Practice address
923 W COLORADO AVE, COLORADO SPRINGS, CO 80905-1517
(719) 432-8477
(719) 227-0303
Mailing address
923 W COLORADO AVE, COLORADO SPRINGS, CO 80905-1517
(719) 432-8477
(719) 227-0303
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1330
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1330
CITY OF MANITOU SPRINGS
CO
Enumeration date
03/16/2007
Last updated
07/08/2007
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