Individual
LARISSA ANN KOZENY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
8660 GRANT RD, SAINT LOUIS, MO 63123-1044
(314) 842-3939
Mailing address
452 MISSION BAY DR, WILDWOOD, MO 63040-1522
(314) 518-1844
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2007011441
MO
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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