Individual
KIRSTEN LYNN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
21255 LIGHT INFANTRY RD, FORT BLISS, TX 79918-8074
(915) 741-6365
Mailing address
21255 LIGHT INFANTRY RD, FORT BLISS, TX 79918-8074
(915) 741-6365
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2601002035
MI
2255A2300X
Athletic Trainer
Primary
AT9909
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000028634
BOC
—
Enumeration date
04/14/2020
Last updated
10/07/2025
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