Individual
MISS ELIZABETH ANN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 FORESTDALE AVE, BEAVERCREEK, OH 45432-3913
(937) 305-8075
Mailing address
1701 FORESTDALE AVE, BEAVERCREEK, OH 45432-3913
(937) 305-8075
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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