Individual
TRAVIS MICHAEL LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1519 S PHILLIPS ST, ALGONA, IA 50511-3649
(515) 295-2451
Mailing address
1519 S PHILLIPS ST, ALGONA, IA 50511-3649
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
099501
IA
Other
Enumeration date
01/20/2020
Last updated
02/17/2021
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