Individual
DR. TOMMY CLYDE LARISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3311 CANDELARIA RD NE, STE K, ALBUQUERQUE, NM 87107-1952
(505) 300-6390
(866) 373-3607
Mailing address
216 SANGRE DE CRISTO, CEDAR CREST, NM 87008-9525
(505) 300-6390
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1714
NM
Other
Enumeration date
11/13/2007
Last updated
03/04/2019
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