Provider Demographics
NPI:1922286889
Name:LARSEN, LINDA (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:LARSEN
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 1:116 VARNER LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-2336
Mailing Address - Country:US
Mailing Address - Phone:540-463-3300
Mailing Address - Fax:
Practice Address - Street 1:116 VARNER LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2336
Practice Address - Country:US
Practice Address - Phone:540-463-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-03
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000244111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA063055OtherANTHIUM BC/BS
VA063055OtherANTHIUM BC/BS