Individual
MARCIA H LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5404
(480) 301-8000
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5404
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
501282
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
909765
—
AZ
01
—
P00188897
RAILROAD MEDICARE
AS
Enumeration date
11/30/2005
Last updated
10/30/2007
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