Provider Demographics
NPI:1356413686
Name:KING, LARRY NEIL (DC)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:NEIL
Last Name:KING
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 1:19392A MONTGOMERY VILLAGE AVE.
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3000
Mailing Address - Country:US
Mailing Address - Phone:301-926-5200
Mailing Address - Fax:301-869-5417
Practice Address - Street 1:19392 MONTGOMERY VILLAGE AVE.
Practice Address - Street 2:SUITE A
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20886-3000
Practice Address - Country:US
Practice Address - Phone:301-926-5200
Practice Address - Fax:301-869-5417
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD466PT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor