ANDREW LARSON

ROSCOE, IL
NPI1558430488
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: IL  070.010783)
Enumeration Date2006-11-07
Last Update Date2007-07-08
Business Address
-- ANDREW LARSON PT
4675 BLUESTEM RD
ROSCOE, IL 61073-7788
Phone number: 815-623-9930
Mailing Address
-- ANDREW LARSON PT
2905 WARE RD
ROCKFORD, IL 61114-6592
Phone number: 815-229-1412
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