Provider Demographics
NPI:1639131626
Name:LITRAKIS, LARRY S (DC)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:S
Last Name:LITRAKIS
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 1:4767 HIGHWAY 58
Mailing Address - Street 2:STE 107
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-2283
Mailing Address - Country:US
Mailing Address - Phone:423-899-1010
Mailing Address - Fax:423-899-1016
Practice Address - Street 1:4767 HIGHWAY 58
Practice Address - Street 2:STE 107
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416-2283
Practice Address - Country:US
Practice Address - Phone:423-899-1010
Practice Address - Fax:423-899-1016
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4117652OtherBCBS
TN4117652OtherBCBS
U42650Medicare UPIN