Individual
MAKENZIE VIOLET LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 JEFFERSON PARK AVE APT 205, CHARLOTTESVILLE, VA 22903-3267
(248) 953-1111
Mailing address
1600 JEFFERSON PARK AVE APT 205, CHARLOTTESVILLE, VA 22903-3267
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/18/2019
Last updated
12/18/2019
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