Individual
MATTHEW LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS ATC, CSCS
Contact information
Practice address
1773 KNAPP ST NE UNIT 6, GRAND RAPIDS, MI 49505-3501
(616) 214-6146
Mailing address
1773 KNAPP ST NE UNIT 6, GRAND RAPIDS, MI 49505-3501
(616) 214-6146
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/30/2020
Last updated
05/03/2021
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