Individual
SARAH LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1400 E BOULDER ST, SUITE 600, COLORADO SPRINGS, CO 80909-5533
(719) 364-6487
(719) 364-6488
Mailing address
1400 E BOULDER ST, SUITE 600, COLORADO SPRINGS, CO 80909-5533
(719) 364-6487
(719) 364-6488
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1349
NE
363A00000X
Physician Assistant
Primary
PA.0004391
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1349
MEDICAL LICENSE
NE
01
—
PA.0004391
MEDICAL LICENSE
CO
Enumeration date
11/29/2007
Last updated
11/30/2016
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