Individual
MR. LARRY L PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 302-2230
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 302-2230
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2010038791
MO
Other
Enumeration date
11/15/2010
Last updated
11/15/2010
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