Individual
JOSHUA A LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, CNP
Contact information
Practice address
133 SPINDER DR STE 4015, EAST PEORIA, IL 61611-0016
(309) 308-5100
(309) 308-5102
Mailing address
133 SPINDER DR STE 4015, EAST PEORIA, IL 61611-0016
(309) 308-5100
(309) 308-5102
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209030314
IL
Other
Enumeration date
08/19/2024
Last updated
10/23/2024
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