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Individual

MR. LARRY R FRESHOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
3010 SE BLVD, # F, SPOKANE, WA 99223
(509) 533-9003
(509) 533-9010
Mailing address
105 W 8TH, # 170, SPOKANE, WA 99204-2312
(509) 838-4700
(509) 838-4716

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 00007067
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
158987
LTI
WA
05
8335135
WA
Enumeration date
02/15/2006
Last updated
04/17/2014
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