Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | 3204 | TX |
NPI | 1285698068 |
---|---|
Provider Name | Larry P Urben |
First Address | Mckinney, TX 75070-8789 |
Second Address | Frisco, TX 75034-7478 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 07/10/2014 |