Provider Demographics
NPI:1124016746
Name:HIRSCHY, LARRY D (DC)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:D
Last Name:HIRSCHY
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 1:801 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHARITON
Mailing Address - State:IA
Mailing Address - Zip Code:50049-1835
Mailing Address - Country:US
Mailing Address - Phone:641-774-4018
Mailing Address - Fax:641-774-7570
Practice Address - Street 1:801 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:CHARITON
Practice Address - State:IA
Practice Address - Zip Code:50049-1835
Practice Address - Country:US
Practice Address - Phone:641-774-9018
Practice Address - Fax:641-774-7570
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04363111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0130773Medicaid
IA0130773Medicaid
IA13077Medicare PIN