Individual
MICHELE MARIE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1831 N 210 W, TOOELE, UT 84074-9124
(435) 224-3161
Mailing address
1831 N 210 W, TOOELE, UT 84074-9124
(435) 224-3161
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
375534-4405
UT
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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