Individual
PHILLIP ERIK LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T. A.
Contact information
Practice address
13075 EVENING CREEK DR S, SAN DIEGO, CA 92128-8101
(209) 531-4613
Mailing address
8034 LINDA VISTA RD APT 1A, SAN DIEGO, CA 92111-5146
(858) 292-6251
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT3876
CA
Other
Enumeration date
09/10/2007
Last updated
09/10/2007
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