Individual
JOHN R. LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1945 STATE ROUTE 33, NEPTUNE, NJ 07753-4859
(732) 776-4292
(732) 776-2428
Mailing address
1945 ROUTE 33, NEPTUNE, NJ 07754
(732) 776-4292
(732) 776-2428
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PAC1053
ND
363AS0400X
Surgical Physician Assistant
Primary
25MP000162
NJ
Other
Enumeration date
08/15/2006
Last updated
09/30/2024
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