Individual
MRS. LARISSA ANN GERHARTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A
Contact information
Practice address
600 W 12TH ST, IMPERIAL, NE 69033-3130
(308) 882-7111
Mailing address
PO BOX 819, IMPERIAL, NE 69033-0819
(308) 882-7111
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
842
NE
Other
Enumeration date
08/23/2011
Last updated
08/23/2011
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