Individual
AUDREY LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3434 W ILLINOIS AVE, DALLAS, TX 75211-8709
(214) 339-9111
Mailing address
243 REEDER DR, COPPELL, TX 75019-4812
(512) 897-0514
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
13303
TX
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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