Individual
LARISSA BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4166 W RIDGE RD, ERIE, PA 16506-1722
(814) 838-2743
(814) 835-1320
Mailing address
4166 W RIDGE RD, ERIE, PA 16506-1722
(814) 838-2743
(814) 835-1320
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN275015
PA
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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