Individual
LARRY THOMAS IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 1ST ST, KEOSAUQUA, IA 52565-7701
(319) 293-3128
(319) 293-3853
Mailing address
601 1ST ST, KEOSAUQUA, IA 52565-7701
(319) 293-3128
(319) 293-3853
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1486
IA
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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