Individual
MR. LARRY GENE CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
2617 ANTILLEY RD, ABILENE, TX 79606-5109
(325) 437-1184
(325) 437-3314
Mailing address
2345 FM 1750, ABILENE, TX 79602-5509
(235) 437-1184
(325) 437-3314
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202625
TX
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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