Individual
JACQUELINE LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
244 WOODDALE LN, WEST END, NC 27376-8754
(910) 638-8811
Mailing address
244 WOODDALE LN, WEST END, NC 27376-8754
(910) 638-8811
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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