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NPI Code Detail

MEDICARE: LARRY A NATIONS PT

MEDICARE:   LARRY A NATIONS  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2004030206MO

General Provider Information

NPI Number : 1023071719
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARRY A NATIONS PT
Provider Business Mailing Address
First Line : PO BOX 1027
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63902-1027
Country : US
Telephone Number : 573-778-9348
Fax Number : 573-686-4870
Provider Business Practice Location Address
First Line : 2725 N WESTWOOD BLVD
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-2346
Country : US
Telephone Number : 573-778-9348
Fax Number : 573-686-4870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 07/09/2007

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Directions to “ LARRY A NATIONS PT” Practice Location

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