Individual
ELLEN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 S 4TH ST, LOUISVILLE, KY 40203-2188
(502) 585-9911
Mailing address
5811 WAVELAND CIR, PROSPECT, KY 40059-8670
(502) 387-7207
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/17/2025
Last updated
03/17/2025
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