Larsen, Larry Nels

Larsen, Larry Nels is an individual health care provider with primary practice located at 1717 Irving Pl , Shreveport LA 71101-4605. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Larsen, Larry Nels can be contacted via phone (318) 425-5604.

Contact Information

Primary practice address
1717 Irving Pl Shreveport LA 71101-4605
Phone: (318) 425-5604
Fax: (318) 222-8165
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 0321 Louisiana

Profile Details

NPI number 1497740088
LBN Legal business name Larsen, Larry Nels
Credentials P.T., A.T.C., S.T.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497740088 NPPES
Louisiana MEDICAID 1112143
Louisiana Other 0321
Louisiana Other 52161
Louisiana Other 00321
Louisiana Other 09098
Louisiana Other 220610
Louisiana Other PT0321

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