Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 207 Kasan Ave, Volga, South Dakota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083849806 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 1144 (South Dakota) | Primary |
Provider Name | Jeremiah E Larsen |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1689868952 PECOS PAC ID: 4082794888 Enrollment ID: I20090605000123 |
Mailing Address | Practice Location Address |
---|---|
Po Box 19, Volga, SD 57071-0019 Ph: (605) 627-9919 | 207 Kasan Ave, Volga, SD 57071 Ph: (605) 627-9919 |
Dr. Jeremiah Emil Larsen, D.C. Chiropractor Medicare: Medicare Enrolled Practice Location: 207 Kasan Ave, Volga, SD 57071 Phone: 605-627-9919 |