Provider Demographics
NPI:1497751820
Name:RHINE, LARRY K (DC)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:K
Last Name:RHINE
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 1:4684 BROADWAY
Mailing Address - Street 2:TILGHMAN SQ
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-3214
Mailing Address - Country:US
Mailing Address - Phone:610-391-0858
Mailing Address - Fax:610-391-0528
Practice Address - Street 1:4684 BROADWAY
Practice Address - Street 2:TILGHMAN SQ
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-3214
Practice Address - Country:US
Practice Address - Phone:610-391-0858
Practice Address - Fax:610-391-0528
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003769L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10934833OtherCAQH PROVIDER ID
PAP1590800OtherOXFORD PROVDER ID
PA94822OtherAETNA PROVIDER ID
PA672331OtherRHINE CHIRO.GROUP #
PA0012339650002OtherMEDICAL ASSISTANCE
PA672331OtherPERSONAL CHOICE
PAP00099430OtherPALMETTO GBA
PAP1590800OtherOXFORD PROVDER ID
PA94822OtherAETNA PROVIDER ID