Individual
KEATON LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
401 E SPRUCE ST, GARDEN CITY, KS 67846-5679
(620) 272-2106
Mailing address
3945 N BLUESTEM DR, GARDEN CITY, KS 67846-9381
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-03801
KS
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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