Individual
MORIAH LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT/L, ATC
Contact information
Practice address
2503 E GARNET AVE, MESA, AZ 85204-6203
(480) 737-2208
Mailing address
2503 E GARNET AVE, MESA, AZ 85204-6203
(480) 737-2208
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1506
AZ
Other
Enumeration date
07/25/2017
Last updated
07/21/2022
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