Individual
MR. LARRY DONALD RUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
92 LINDA VISTA ST, BENICIA, CA 94510-2231
(510) 410-1892
Mailing address
92 LINDA VISTA ST, BENICIA, CA 94510-2231
(510) 410-1892
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT4222
CA
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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