Individual
LARSEN HOLYOAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10408495-2401
UT
2255A2300X
Athletic Trainer
10408495-4810
UT
Other
Enumeration date
06/23/2017
Last updated
11/03/2023
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