Dr. Larry E J Russell , DC
Chiropractor • Beaver Dam, WI
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Larry Russell has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Larry Russell, DC was a registered Chiropractor practicing in Beaver Dam, WI. Throughout an active medical career spanning 15 years, Dr. Russell provided care at the practice location at 604 SCOTT ST until profile deactivation on 2022-02-18.
Practice Location & Contact Primary Location
604 Scott St
Beaver Dam, WI 539161024
Specialty Benchmarks & Practice Insights
Comparative analytics for Chiropractor in Beaver Dam, WI
Practicing in Beaver Dam, WI (2664 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 111N00000X
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.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Chiropractor
Doctor of Chiropractic
Physical Therapist
Doctor of Physical Therapy
Chiropractor
Chiropractor
Doctor of Chiropractic
Chiropractor
Doctor of Chiropractic
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on February 18, 2022
NPI status registered as active in NPPES database
Registered at 604 SCOTT ST, BEAVER DAM, WI 539161024 (Tel: 9208877156)
Registered at 250 CORPORATE DR, BEAVER DAM, WI 53916 (Tel: 9208877156)
Recorded as LARRY RUSSELL, DC
Chiropractor (License #1286012 in WI)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
250 Corporate Dr
Beaver Dam, WI 53916
Phone: 9208877156
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