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NPI Code Detail

MEDICARE: LARRY D POWERS CP, ROA

MEDICARE: LARRY D POWERS CP, ROA
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
11744P3200XProsthetics Case Management

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932251147
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARRY D POWERS CP, ROA
Provider Business Mailing Address
First Line : 3944 FIRESTONE RD
Second Line :
City : KERNERSVILLE
State : NC
Zip : 27284-9229
Country : US
Telephone Number : 336-992-0262
Fax Number : 336-333-9083
Provider Business Practice Location Address
First Line : 2301 N CHURCH ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-4309
Country : US
Telephone Number : 336-333-9081
Fax Number : 336-333-9083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2007
Last Update Date : 07/09/2007

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