Individual
MR. THOMAS ERIC LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 268-6511
Mailing address
102 S MAPLE ST, GERMANTOWN, OH 45327-1219
(937) 855-2103
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2224
OH
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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