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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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