Individual
LARRY GENE DEARFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA47738
Contact information
Practice address
4611 EDGEWATER DR, ORLANDO, FL 32804-1121
(407) 451-0219
Mailing address
4611 EDGEWATER DR, ORLANDO, FL 32804-1121
(407) 451-0219
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA47738
FL
Other
Enumeration date
06/29/2009
Last updated
06/29/2009
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