Individual
MRS. JESSICA JANE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
10300 W 103RD ST, SUITE 300, OVERLAND PARK, KS 66214-2642
(913) 894-1910
Mailing address
2711 COUNTRY CLUB AVE, OMAHA, NE 68104-4222
(402) 505-3294
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2249
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2249
STATE LICENSE
NE
Enumeration date
04/09/2008
Last updated
04/09/2008
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