Individual
JOHN DYLAN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 WOODRUFF CIR NE, ATLANTA, GA 30322-1020
(140) 472-7845
(404) 727-8454
Mailing address
550 JOHN WESLEY DOBBS AVE NE APT B, ATLANTA, GA 30312-1700
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/13/2017
Last updated
07/13/2017
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