Doctor Name: | ROBERT L LARSON |
NPI Number: | 1306067335 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 1065415TX |
Business Practice Address: | 1617 Park Place Ave Ste 110 Ft Worth, TX - 761101300 |
Business Phone Number: | 8179231800 |
Business Fax Number: | 8179232059 |
Mailing Address: | 1617 Park Place Ave, Ste 110 FT WORTH |
State: | TX |
Postal Code: | 761101300 |
Phone Number: | 8179231800 |
Fax Number: | 8179232059 |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1065415TX |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |