Individual
LARRY LEE THIRSTRUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
609 BROWNSWITCH RD, SLIDELL, LA 70458-1233
(985) 649-7357
Mailing address
200 OLYMPIA DR, SLIDELL, LA 70460-3222
(985) 649-7357
(985) 641-9897
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LA05574R
LA
Other
Enumeration date
10/24/2007
Last updated
10/24/2007
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