Individual
AMANDA BETH LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1925 DOMINION WAY FL 1, COLORADO SPRINGS, CO 80918-1483
(719) 300-5735
Mailing address
1925 DOMINION WAY FL 1, COLORADO SPRINGS, CO 80918-1483
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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