Individual
JAMIE LYNN LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1010 BRYDEN AVE, SUITE A, LEWISTON, ID 83501-2713
(208) 746-0455
(208) 746-0688
Mailing address
1019 3RD ST, LEWISTON, ID 83501-2713
(208) 746-0455
(208) 746-0688
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
00010795
WA
225100000X
Physical Therapist
Primary
2265
ID
Other
Enumeration date
08/24/2010
Last updated
10/20/2010
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