Provider Demographics
NPI:1255540050
Name:LARNED, RICHARD WILLIAM (BS, MS, DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:WILLIAM
Last Name:LARNED
Suffix:
Gender:M
Credentials:BS, MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22305 CARLETON AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-6710
Mailing Address - Country:US
Mailing Address - Phone:248-586-9191
Mailing Address - Fax:
Practice Address - Street 1:2965 12 MILE RD STE 200
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1436
Practice Address - Country:US
Practice Address - Phone:248-586-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor