Individual
LARRY D BRIAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PT, ATC
Contact information
Practice address
2717 18TH ST, SUITE 100, KENOSHA, WI 53140-4666
(262) 551-5650
(866) 245-8064
Mailing address
PO BOX 3497, STURTEVANT, WI 53177-3497
(888) 201-1040
(866) 245-8064
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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