Individual
JONATHAN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8700 E 29TH ST N, WICHITA, KS 67226-2169
(316) 634-8700
Mailing address
8700 E 29TH ST N, WICHITA, KS 67226-2169
(316) 634-8700
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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