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Individual

MR. JAMES ROBERT LARSEN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
A.T.C. L.A.T.

Contact information

Practice address
387 N FERRIS ST, APT L, POWELL, WY 82435-2042
(307) 359-0617
Mailing address
387 N FERRIS ST, APT L, POWELL, WY 82435-2042
(307) 359-0617

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
011
WY

Other

Enumeration date
12/19/2011
Last updated
12/19/2011
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