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1447410279
BROCK RUSSELL LARSON
HOUSTON, TX
NPI
1447410279
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TX 2062500)
Enumeration Date
2008-06-16
Last Update Date
2008-06-16
Business Address
Mr. BROCK RUSSELL LARSON PTA
9180 KATY FWY STE 200
HOUSTON, TX 77055-7443
Phone number: 713-984-1400
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Mailing Address
Mr. BROCK RUSSELL LARSON PTA
310 E HEARD ST
GANADO, TX 77962-8413
Phone number: 361-771-5956
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