Provider Demographics
NPI:1194365163
Name:ARMSTRONG-KAGER, LARISSA ANNE (DC)
Entity Type:Individual
Prefix:
First Name:LARISSA
Middle Name:ANNE
Last Name:ARMSTRONG-KAGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4051 IRVING PL
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2809
Mailing Address - Country:US
Mailing Address - Phone:214-960-9651
Mailing Address - Fax:
Practice Address - Street 1:4051 IRVING PL
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2809
Practice Address - Country:US
Practice Address - Phone:214-960-9651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14304111N00000X
CA36071111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor