Individual
BRIAN LARUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J10002000
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10000040229
AMERIHEALTH/IBC
PA
05
—
1000038248
—
DE
01
—
105165
PA BCBS
PA
01
—
5070-0053
CAREFIRST
—
01
—
88760507
CAREFIRST
—
01
—
J10002000
DE LICENSE
DE
Enumeration date
01/12/2007
Last updated
03/04/2013
Update your record
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