Individual
OLIVIA ANNE LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
6165 W EMERALD ST, BOISE, ID 83704-8613
(208) 302-3500
Mailing address
9393 W BEACON LIGHT RD, STAR, ID 83669-5109
(208) 971-9592
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/29/2026
Last updated
07/29/2026
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