Individual
JASON REX LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1155 S POWER RD STE 144, MESA, AZ 85206-3715
(800) 402-0881
Mailing address
32344 N 133RD DR, PEORIA, AZ 85383-6113
(909) 434-6074
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
278030
AZ
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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