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Individual
KATHRYN L LARSSON
Active
Individual
KATHRYN L LARSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4069
TX
152W00000X
Optometrist
Primary
9225T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0092250
—
CA
Enumeration date
09/08/2005
Last updated
07/30/2022
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