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Individual
LARRY D BRIAND
Active
Individual
LARRY D BRIAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PT, ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4072024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00186666001
MEDICAID
IL
05
—
40189400
—
WI
01
—
87951
MEDICARE
IL
Enumeration date
06/08/2006
Last updated
12/04/2014
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