Individual
LARRY LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
39 MOTIF BLVD, BROWNSBURG, IN 46112-1017
(217) 776-3302
Mailing address
39 MOTIF BLVD, BROWNSBURG, IN 46112-1017
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
34009743A
IN
Other
Enumeration date
04/24/2022
Last updated
01/17/2024
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