Individual
MR. LAWRENCE ANDREW LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
123 MEDICAL CENTER DR, BRUNSWICK, ME 04011
(207) 373-6183
(207) 373-6178
Mailing address
123 MEDICAL CENTER DR, BRUNSWICK, ME 04011-2652
(207) 373-6183
(207) 673-6178
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1806
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432015500
—
ME
Enumeration date
04/07/2006
Last updated
07/03/2018
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