| Doctor Name: | MR. LARRY MICHAEL SULHAM |
| NPI Number: | 1295973212 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT009687 |
| Business Practice Address: | 25528 Magnolia Ln Stevenson Ranch, CA - 913811843 |
| Business Phone Number: | 6612543369 |
| Business Fax Number: | 6612534536 |
| Mailing Address: | 25528 Magnolia Ln, STEVENSON RANCH |
| State: | CA |
| Postal Code: | 913811843 |
| Phone Number: | 6612543369 |
| Fax Number: | 6612534536 |
| NPI Enumeration Date: | 01/29/2009 |
| NPI Last Update Date: | 01/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | PT009687 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |