Individual
LARISSA ANN KOHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2615 FAIRWAY ST, DICKINSON, ND 58601
(701) 456-6000
Mailing address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-7000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
865
ND
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/08/2012
Last updated
07/12/2018
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