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1003318726
LARISSA DYAN KIRK
AUSTIN, TX
NPI
1003318726
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NE 19572)
Enumeration Date
2018-03-08
Last Update Date
2018-03-08
Business Address
LARISSA DYAN KIRK
1631 E 2ND ST
AUSTIN, TX 78702-4490
Phone number: 512-455-7787
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Mailing Address
LARISSA DYAN KIRK
1430 COLLIER ST
AUSTIN, TX 78704-2911
Phone number: 512-472-4357
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