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LARISSA AGUADO

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1629639745

Individual Registrant:
 LARISSA  AGUADO 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1504 HIGHWAY 74 N STE 2A  TYRONE, GA 30290-1663 US
Tel: 470-885-5967  Fax: --

Contact information for business:
1100 CIRCLE 75 PKWY SE STE 1400  ATLANTA, GA 30339-3067 US
Tel: --  Fax: --

Registration Information:
NPI: 1629639745
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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