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Theodore Larew
NPI 1154669422 · on the registry since 2013
Practice
- Address
- 4357 Beaver Pond Ct
Loganville, GA 30052 - Phone
- (770) 682-2433
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-01-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia