Individual
LARRY L BACZURIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6122
(864) 560-6276
Mailing address
PO BOX 277723, ATLANTA, GA 30384-7723
(864) 560-4123
(864) 560-4023
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN 814
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN0177
—
SC
Enumeration date
04/10/2006
Last updated
12/30/2011
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