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Individual

KATHRYN LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
4064 POSTAL DR, ROANOKE, VA 24018-6438
(540) 776-0208
(540) 777-5847
Mailing address
4064 POSTAL DR, ROANOKE, VA 24018-6438
(540) 776-0208
(540) 777-5847

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OTR485
WY
225XH1200X
Hand Occupational Therapist
Primary
0119004545
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
312199
BCBS
01
P00081343
RAILROAD MEDICARE
Enumeration date
01/20/2006
Last updated
11/06/2007
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