Provider Demographics
NPI:1548551187
Name:LARSON, CHRISTOPHER J (DC, CERT ACU)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:LARSON
Suffix:
Gender:M
Credentials:DC, CERT ACU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-2535
Mailing Address - Country:US
Mailing Address - Phone:320-763-6533
Mailing Address - Fax:320-763-6534
Practice Address - Street 1:1413 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2535
Practice Address - Country:US
Practice Address - Phone:320-763-6533
Practice Address - Fax:320-763-6534
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-01
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN912171100000X
MN5527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist