Individual
BRIAN THERALD LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1300 N 500 E, LOGAN, UT 84341-2408
(435) 716-2880
Mailing address
1300 N 500 E, LOGAN, UT 84341-2408
(435) 716-2880
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
352702-2401
UT
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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