Provider Information for 1083211049
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Mr. CUB JOSEPH LARKIN M.S., NCC
Sex: Male
NPI: 1083211049
Last Updated: 2022-07-05
Certification Date: 2022-07-05
Certification Date: 2022-07-05
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1083211049 | ||||||||
| Enumeration Date | 2020-10-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 800 NW 29TH CT WILTON MANORS, FL 33311-2436 United States Phone: 954-892-5552 | Fax:954-405-8948 | ||||||||
| Primary Practice Address | 800 NW 29TH CT WILTON MANORS, FL 33311-2436 United States Phone: 954-892-5552 | Fax:954-405-8948 | ||||||||
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