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Individual

CHAD EUGENE LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CHIROPRACTOR

Contact information

Practice address
4910 OLD CHENEY RD, UNIT 1A, LINCOLN, NE 68516-3107
(402) 421-1626
(402) 421-1671
Mailing address
4910 OLD CHENEY RD, UNIT 1A, LINCOLN, NE 68516-3107
(402) 421-1626
(402) 421-1671

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1204
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09728
BCBS
NE
Enumeration date
08/17/2006
Last updated
08/15/2012
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