Individual
MS. BRENDA VIRGINIA LAROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
964 MAIN ST, LEICESTER, MA 01524-1310
(774) 354-0490
Mailing address
47 STAFFORD ST, APARTMENT 2, WORCESTER, MA 01603-1422
(518) 527-4043
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2027
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
MA
Enumeration date
02/28/2010
Last updated
02/28/2010
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