DR. LARRY E J RUSSELL (NPI# 1881809242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881809242 |
| Entity Type | Individual |
| Full Name | DR. LARRY E J RUSSELL |
| Credential | DC |
| Practice Address |
604 Scott St Beaver Dam WI 53916-1024 |
| Mailing Address |
250 Corporate Dr Beaver Dam WI 53916 |
| Practice Telephone | 9208877156 |
| Practice Fax Number | 9208877290 |
| Mailing Telephone | 9208877156 |
| Mailing Fax Number | 9208877290 |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2009-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 1286012 | WI | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053500975 | Larry Doby Russell | Dentist | 519 W Euclid Ave, Phoenix, AZ 85041-8440 | 2007-10-16 |
| 1588765614 | Larry Wayne Russell | Social Worker | 70 Parcoal Rd, Webster Springs, WV 26288-9767 | 2006-09-25 |
| 1841228731 | Larry J Russell | Chiropractor | 406 East South Boulevard, Crawfordsville, IN 47933 | 2006-06-29 |
| 1811987431 | Larry James Russell | Pharmacist | 40 Holly Hill Dr, Elizabethtown, KY 42701-8917 | 2005-10-25 |
| 1164079646 | Larry Russell | Chore Provider | 6725 S Eastern Ave Ste 1, Las Vegas, NV 89119-3949 | 2019-08-20 |
| 1891772513 | Larry Joe Russell | Family Medicine | 510 Balsam Rd, Hendersonville, NC 28792-5703 | 2005-12-22 |
| Street Address |
604 SCOTT ST |
| City | BEAVER DAM |
| State | WI |
| Zip Code | 53916-1024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538718283 | Paulette Neibauer | Technician | N7262 Farwell Rd., Beaver Dam, WI 53916 | 2019-09-05 |
| 1902336597 | Tricounty Homecare Inc | In Home Supportive Care | 140 Corporate Dr Ste 2, Beaver Dam, WI 53916 | 2017-06-15 |
| 1528502754 | Jessica Marie Blatz | Counselor | 809 Park Aveune, Beaver Dam, WI 53916 | 2016-12-07 |
| 1376090886 | Beaver Dam Hearing Care, LLC | Hearing Aid Equipment | 705 University Ave, Suite 170, Beaver Dam, WI 53916 | 2016-09-01 |
| 1275902546 | Beaver Dam Community Hospitals Inc | Pharmacy | 705 S University Ave Ste 180, Beaver Dam, WI 53916 | 2015-09-17 |
| 1609242825 | Tami Joe Delisle | Counselor | 207 North Spring Street, Beaver Dam, WI 53916 | 2015-08-12 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1326471608 | Raquel Rodriguez-guzman | Pharmacist | 205 La Crosse Street, Beaver Dam, WI 53916 | 2013-08-09 |
| 1558608828 | Mary Y Kunz | Licensed Practical Nurse | 6550 N Highway 151 Lot 63, Beaverdam, WI 53916 | 2013-01-07 |
| 1881938454 | Brock Holden Slinger | Physical Therapist | 205 Monroe St. #13, Beaver Dam, WI 53916 | 2012-11-20 |
| Find all providers in zip 53916 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467832899 | Kluewer Chiropractic, Inc | Chiropractor | 1229 N Center St, Beaver Dam, WI 53916-1147 | 2015-06-01 |
| 1104993658 | Jerome E Tyjeski | Chiropractor | 119 E Mackie St, Beaver Dam, WI 53916-2031 | 2006-11-29 |
| 1083796643 | Roger Clarence Hasbrouck | Chiropractor | 915 Madison St, Beaver Dam, WI 53916-2623 | 2006-10-20 |
| 1518989631 | Benjamin David Shier | Chiropractor | 211 Corporate Dr, Suite H, Beaver Dam, WI 53916-3119 | 2006-07-25 |
| 1003845587 | Dale R Alt | Chiropractor | 127 Park Ave, Beaver Dam, WI 53916-2107 | 2006-06-30 |
| 1962454249 | Jenifer E Espenscheid | Chiropractor | 105 Warren St, Suite #1, Beaver Dam, WI 53916-3012 | 2006-05-16 |
| 1932190311 | Lentscher Brothers LLC | Chiropractor | 250 Corporate Dr., Beaver Dam, WI 53916 | 2005-11-03 |
| 1033100193 | William Patrick Lentscher | Chiropractor | 250 Corporate Dr, Beaver Dam, WI 53916 | 2005-10-28 |
| 1639647605 | Lentscher Brothers LLC | Chiropractor | 250 Corporate Dr., Beaver Dam, WI 53916 | 2018-11-08 |
| 1639615941 | Stephanie Kaye Tyjeski | Chiropractor | 119 E Mackie St, Beaver Dam, WI 53916-2031 | 2017-01-10 |
| Find all providers in BEAVER DAM | ||||
| City | BEAVER DAM |
| Zip Code | 53916 |
Please comment or provide details below to improve the information on DR. LARRY E J RUSSELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.