Individual
MRS. ROXANNA LEIGH LARSEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
400 E 2ND ST, BLOOMSBURG, PA 17815-1301
(570) 389-4668
Mailing address
1761 MAIN ST, BLOOMSBURG, PA 17815-8841
(570) 387-5121
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
PA
Other
Enumeration date
06/17/2006
Last updated
07/08/2007
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