Provider Demographics
NPI:1114002235
Name:WILLIAMS, LARRY CURT (DC)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:CURT
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 BERRY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5630
Mailing Address - Country:US
Mailing Address - Phone:408-230-0536
Mailing Address - Fax:
Practice Address - Street 1:807 BERRY CREEK DR
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5630
Practice Address - Country:US
Practice Address - Phone:408-230-0536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0165880Medicare ID - Type Unspecified