Provider Demographics
NPI:1851504781
Name:EMERY, LARRY HENRY (DC)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:HENRY
Last Name:EMERY
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:W610 HUBBARD ST. SUITE 116
Mailing Address - Street 2:
Mailing Address - City:COEUR D' ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814
Mailing Address - Country:US
Mailing Address - Phone:208-664-9134
Mailing Address - Fax:208-666-1623
Practice Address - Street 1:W610 HUBBARD ST. SUITE 116
Practice Address - Street 2:
Practice Address - City:COEUR D' ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814
Practice Address - Country:US
Practice Address - Phone:208-664-9134
Practice Address - Fax:208-666-1623
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-271111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1670231Medicare ID - Type Unspecified