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Individual

MS. SUSANNA MARIE LARNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L-ATC

Contact information

Practice address
189 HORNET RD, FISHERSVILLE, VA 22939-3413
(540) 886-4286
(540) 886-4611
Mailing address
189 HORNET RD, FISHERSVILLE, VA 22939-3413
(540) 886-4286
(540) 886-4611

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000288
VA

Other

Enumeration date
12/14/2012
Last updated
12/14/2012
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