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Larry Fredric Radke, DC
Chiropractor in Lake City, Florida
NPI 1649481052

Larry Fredric Radke is a Chiropractor based in Lake City, FL. Larry Fredric Radke practices in Lake City, FL and has the professional credentials of DC. The NPI Number for Larry Fredric Radke is 1649481052 and holds a License No. CH0002067 (Florida).

The current practice location address for Larry Fredric Radke is 430 Sw Columbia Ave, Lake City, FL and can be reached out via phone at 386-752-2252 and via fax at 386-754-5088. You can also correspond with Larry Fredric Radke through the mailing address at 430 SW COLUMBIA AVE, LAKE CITY, FL - 32025-5254 (mailing address contact number: 386-752-2252).

Location: 430 Sw Columbia Ave, Lake City, FL, 32025-5254
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649481052
Provider Name
Larry Fredric Radke
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
430 Sw Columbia Ave, Lake City, FL, 32025-5254
Phone Number
386-752-2252
Fax Number
386-754-5088
Provider Enumeration Date
05/25/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
89714 01 FL BLUECROSS BLUESHIELD PROV
institution
Provider Business Practice Location Address Details
Address
430 Sw Columbia Ave
City
Lake City
State
Florida
Zip
32025-5254
Phone Number
386-752-2252
Fax Number
386-754-5088
person
Provider Business Mailing Address Details
Address
430 Sw Columbia Ave
City
Lake City
State
Florida
Zip
32025-5254
Phone Number
386-752-2252
Fax Number
386-754-5088
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
CH0002067 (Florida)
Definition
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.
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