Individual
MR. GREGORY THOMAS LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
167 NE KAMIAKEN ST, (MEZZANINE), PULLMAN, WA 99163-2611
(509) 332-0555
(509) 334-9522
Mailing address
167 NE KAMIAKEN ST, (MEZZANINE), PULLMAN, WA 99163-2611
(509) 332-0555
(509) 334-9522
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MA00015575
WA
Other
Enumeration date
10/16/2007
Last updated
10/16/2007
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