Provider Demographics
NPI:1841232865
Name:GIES, LARRY WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:WAYNE
Last Name:GIES
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 1:1585 BUTTE HOUSE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-2200
Mailing Address - Country:US
Mailing Address - Phone:530-673-8792
Mailing Address - Fax:530-673-0151
Practice Address - Street 1:1585 BUTTE HOUSE RD
Practice Address - Street 2:SUITE A
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-2200
Practice Address - Country:US
Practice Address - Phone:530-673-8792
Practice Address - Fax:530-673-0151
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0180950Medicare ID - Type Unspecified
CATO6622Medicare UPIN