Individual
MRS. LARISSA GIZELLE NEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1640 REDSTONE CENTER DR, 200, PARK CITY, UT 84098-7605
(888) 800-8744
Mailing address
44863 MILESTONE SQ, 302, ASHBURN, VA 20147-4203
(703) 729-7311
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
2305204903
VA
Other
Enumeration date
05/26/2008
Last updated
05/26/2008
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