Provider Demographics
NPI:1669641072
Name:LARIMORE CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:LARIMORE CHIROPRACTIC, PC
Other - Org Name:CATALINA MOUNTAIN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:LARIMORE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-825-3103
Mailing Address - Street 1:PO BOX 8681
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85738-0681
Mailing Address - Country:US
Mailing Address - Phone:520-825-3103
Mailing Address - Fax:520-825-2225
Practice Address - Street 1:3777 E GOLDER RANCH DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9797
Practice Address - Country:US
Practice Address - Phone:520-825-3103
Practice Address - Fax:520-825-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z5617OtherHEALTHNET
AZ1024511OtherAMERICAN SPECIALTY HEALTH
AZ1053495796OtherBLUE CROSS BLUE HIELD AZ
AZ623176OtherAM CHIRO NETWORK
AZ421915OtherCOVENTRY
AZ2455270OtherAETNA
AZ421915OtherCOVENTRY
AZ=========OtherUNITED HEALTH CARE
AZ623176OtherAM CHIRO NETWORK