Provider Demographics
NPI:1831458223
Name:RICE, LARISSA MARIA (DC)
Entity Type:Individual
Prefix:DR
First Name:LARISSA
Middle Name:MARIA
Last Name:RICE
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 1:1642 MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-2686
Mailing Address - Country:US
Mailing Address - Phone:913-367-1665
Mailing Address - Fax:
Practice Address - Street 1:1642 MAIN ST
Practice Address - Street 2:STE. #3
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-2686
Practice Address - Country:US
Practice Address - Phone:913-367-1665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05471111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor