Individual
MS. LARISA ANN DURRENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7575 5 MILE RD, CINCINNATI, OH 45230-4346
(513) 233-4360
(513) 233-4361
Mailing address
7575 5 MILE RD, CINCINNATI, OH 45230-4346
(513) 233-4360
(513) 233-4361
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT11274
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000379773
ANTHEM
OH
05
—
2611463
—
OH
01
—
9408412
PHCS
OH
01
—
P00309809
MEDICARE RAILROAD
—
Enumeration date
12/13/2005
Last updated
01/08/2014
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