Individual
CRAIG M LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPRC, CPRC-S
Contact information
Practice address
304 W LOGAN ST, CALDWELL, ID 83605-4735
(208) 402-6782
Mailing address
304 W LOGAN ST, CALDWELL, ID 83605-4735
(208) 402-6782
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
11926
ID
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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