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Organization

LARSON REHABILITATION SERVICES, PLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ZANE LARSON LARSON PT, DPT, ECS, OCS (MEMBER)
(928) 526-3031
Entity
Organization

Contact information

Practice address
1600 W UNIVERSITY AVE, STE 106, FLAGSTAFF, AZ 86001-3114
(928) 526-3031
(928) 526-3098
Mailing address
1600 W UNIVERSITY AVE, STE 106, FLAGSTAFF, AZ 86001-3114
(928) 526-3031
(928) 526-3098

Taxonomy

Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
2251E1300X
Clinical Electrophysiology Physical Therapist
5758
AZ
2251X0800X
Orthopedic Physical Therapist
Primary
5758
AZ

Other

Enumeration date
03/01/2010
Last updated
01/16/2019
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