Individual
SAMANTHA JO LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 10TH AVE, MENOMINEE, MI 49858-3058
(906) 290-5000
(906) 863-2408
Mailing address
1110 10TH AVE, MENOMINEE, MI 49858-3058
(906) 290-5000
(906) 863-2408
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
MI
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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