Individual
ERIC LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-3111
Mailing address
P.O. BOX 759101, BALTIMORE, MD 21275-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001785
VA
Other
Enumeration date
03/20/2006
Last updated
01/11/2013
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