Individual
DR. MARIO LAROUCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., M.AC.O.M.
Contact information
Practice address
100 ELK RUN DR, SUITE 202, BASALT, CO 81621-9205
(970) 927-1262
Mailing address
100 ELK RUN DR, SUITE 202, BASALT, CO 81621-9205
(970) 927-1262
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
CHR.0003878
CO
Other
Enumeration date
04/01/2015
Last updated
04/01/2015
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