Individual
MRS. ALISHA MARIE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH BS
Contact information
Practice address
29 BLACK COAL DRIVE, FORT WASHAKIE, WY 82514
(307) 332-3527
Mailing address
1210 MCDOUGALL DR, LANDER, WY 82520-3531
(307) 335-5960
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
747
WY
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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