Individual
AIMEE SUSAN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
462 GRIDER ST, SUNY CC BUILDING, BUFFALO, NY 14215-3021
(716) 898-5272
Mailing address
12 SWEET BRIAR CT, TONAWANDA, NY 14150-7506
(716) 833-3850
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
014597
NY
Other
Enumeration date
01/28/2011
Last updated
01/28/2011
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