Provider Demographics
NPI:1265613988
Name:MASULA, LARRY SCHOW (DC)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:SCHOW
Last Name:MASULA
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 1:890 SUNSET DR
Mailing Address - Street 2:STE D2C
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-5664
Mailing Address - Country:US
Mailing Address - Phone:831-637-9283
Mailing Address - Fax:831-637-9483
Practice Address - Street 1:890 SUNSET DR
Practice Address - Street 2:STE D2C
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5664
Practice Address - Country:US
Practice Address - Phone:831-637-9283
Practice Address - Fax:831-637-9483
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30721111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor