Individual
LARRY FREDRICK KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4408 E 158TH ST, CLEVELAND, OH 44128-2917
(614) 373-7535
Mailing address
4408 E 158TH ST, CLEVELAND, OH 44128-2917
(614) 373-7535
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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