Individual
TIFFANY LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6265 ROCK CHALK DR UNIT 1500, LAWRENCE, KS 66049-5238
(785) 843-9125
Mailing address
325 MAINE STREET, MSO LIBRARY, LAWRENCE, KS 66044
(785) 505-2988
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-03069
KS
Other
Enumeration date
04/03/2025
Last updated
05/13/2025
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