Individual
JESSIE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13 REBECCA LN, KILLINGWORTH, CT 06419-1455
(203) 376-6026
Mailing address
13 REBECCA LN, KILLINGWORTH, CT 06419-1455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
033582
CT
Other
Enumeration date
05/21/2016
Last updated
05/21/2016
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