Individual
JESSE LEE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
5005 N PIEDRAS ST, WBAMC RECOVERY ROOM, EL PASO, TX 79920-5001
(915) 569-2571
Mailing address
3229 EL MORRO RD, EL PASO, TX 79904-3006
(915) 307-3339
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
623686
TX
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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