Individual
LARRY L TOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.001791
IL
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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