Provider Demographics
NPI:1871715235
Name:LARRY D GUINN DC INC
Entity type:Organization
Organization Name:LARRY D GUINN DC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:GUINN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-729-1619
Mailing Address - Street 1:2477 SHORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43611-1567
Mailing Address - Country:US
Mailing Address - Phone:419-729-1619
Mailing Address - Fax:419-729-1675
Practice Address - Street 1:2477 SHORELAND AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43611-1567
Practice Address - Country:US
Practice Address - Phone:419-729-1619
Practice Address - Fax:419-729-1675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH632111N00000X
MI2961111N00000X
GA5111111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0319159Medicaid
OH0319159Medicaid
OHLA0429291Medicare ID - Type Unspecified