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Individual

ELAINE LARSON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
GAYLORD FARMS RD., WALLINGFORD, CT 06492
(203) 284-2800
(203) 679-3598
Mailing address
GAYLORD FARMS RD., PO BOX 400, WALLINGFORD, CT 06492
(203) 284-2800
(203) 679-3598

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000101
CT

Other

Enumeration date
06/15/2006
Last updated
07/08/2007
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