Individual
MR. JEFF WILLIAM LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2815
(919) 424-5080
Mailing address
7700 BRANDYWOOD CT, RALEIGH, NC 27615-6102
(919) 931-4059
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A3187
NC
Other
Enumeration date
02/14/2012
Last updated
02/14/2012
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