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Dr. Larry Dale Kinnison

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NPI Number Detailed Information

Provider Information:

Name: Dr. Larry Dale Kinnison
Gender: M
Provider License Number If Given: 2252

NPI Information:

NPI: 1659366185
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 7/8/2010

Provider Business Mailing Address:

Address: PO BOX 878
Marble Falls, TX 78654
Phone Number: 8306935502
Fax Number: 8306935503

Provider Business Practice Location Address:

Address: 900 AVENUE J
Marble Falls, TX 78654
Phone Number: 8306935502
Fax Number: 8306935503

Provider Taxonomy:

Primary: 111N00000X
Secondary (if any):
State: TX

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