Provider Demographics
NPI:1174688428
Name:ROSSI, LARRY HENRY (PT)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:HENRY
Last Name:ROSSI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 N. WESTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072
Mailing Address - Country:US
Mailing Address - Phone:806-291-0141
Mailing Address - Fax:806-291-3322
Practice Address - Street 1:109 N. WESTRIDGE RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072
Practice Address - Country:US
Practice Address - Phone:806-291-0141
Practice Address - Fax:806-291-3322
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1093086225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist