Larsen, Mark William

Larsen, Mark William is an individual health care provider with primary practice located at 7 N Wabash St , Peru IN 46970-2224. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Larsen, Mark William can be contacted via phone (765) 472-1127.

Contact Information

Primary practice address
7 N Wabash St Peru IN 46970-2224
Phone: (765) 472-1127
Fax: (765) 472-5228
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 08001019A Indiana

Profile Details

NPI number 1043335078
LBN Legal business name Larsen, Mark William
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043335078 NPPES
Indiana Other 000000092330 ANTHEM WELLPOINT

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