Doctor Name: | MR. LARRY T ROSSOW |
NPI Number: | 1003089939 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 07046 |
Business Practice Address: | 306 N 3rd Ave E Newton, IA - 502083249 |
Business Phone Number: | 6417924012 |
Business Fax Number: | 6417910697 |
Mailing Address: | 306 N 3rd Ave E, NEWTON |
State: | IA |
Postal Code: | 502083249 |
Phone Number: | 6417924012 |
Fax Number: | 6417910697 |
NPI Enumeration Date: | 04/11/2008 |
NPI Last Update Date: | 04/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 07046 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |