Provider Demographics
NPI:1801918016
Name:BEHM, LARRY E (DC)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:E
Last Name:BEHM
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 1:3961 PERKIOMEN AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-2718
Mailing Address - Country:US
Mailing Address - Phone:610-779-2522
Mailing Address - Fax:610-779-2527
Practice Address - Street 1:3961 PERKIOMEN AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-2718
Practice Address - Country:US
Practice Address - Phone:610-779-2522
Practice Address - Fax:610-779-2527
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003747L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABE570050OtherBLUE SHIELD ID#
PAU02522Medicare UPIN
PABE570050Medicare ID - Type UnspecifiedMEDICARE ID #