Individual
MRS. IVY ANN LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFA
Contact information
Practice address
1524 W 5TH ST, SHERIDAN, WY 82801-2707
(307) 751-1774
(307) 673-0655
Mailing address
1524 W 5TH ST, SHERIDAN, WY 82801-2707
(307) 751-1774
(307) 673-0655
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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