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Individual
THOMAS M LARSON
Active
Individual
THOMAS M LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT19145
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008872100
—
FL
01
—
PT19145
FLORIDA LICENSE
FL
01
—
Y09JU
BCBSFL
FL
Enumeration date
06/21/2010
Last updated
04/21/2014
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