Kotewa, Larry J

Kotewa, Larry J is an sole proprietor health care provider with primary practice located at 124 W Whitehall Ct , Peoria IL 61614-3032. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Kotewa, Larry J can be contacted via phone (309) 691-2607.

Contact Information

Primary practice address
124 W Whitehall Ct Peoria IL 61614-3032
Phone: (309) 691-2607
Fax: (309) 683-1003
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X Illinois

Profile Details

NPI number 1942278130
LBN Legal business name Kotewa, Larry J
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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