Individual
WALTER LARSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
40 CENTRE ST, CONCORD, NH 03301-4214
(603) 224-3511
(603) 224-3556
Mailing address
1 CREDIT UNION WAY FL 3, RANDOLPH, MA 02368-4633
(781) 961-3370
(781) 961-1291
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3128
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3090179
—
NH
01
—
7640829
AETNA
NH
Enumeration date
05/15/2006
Last updated
01/05/2018
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