Individual
MS. LARA ELIZABETH HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
2511 FAIRLANE DR STE C100, MONTGOMERY, AL 36116-1649
(334) 215-0034
Mailing address
2511 FAIRLANE DR STE C100, MONTGOMERY, AL 36116-1649
(334) 215-0034
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2393
AL
Other
Enumeration date
01/15/2007
Last updated
07/08/2007
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