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Individual

MARCUS JOHN LARSON III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, LAT

Contact information

Practice address
1401 W COUNTY LINE RD, GREENWOOD, IN 46142-5195
(317) 496-1248
Mailing address
3416 WINCHESTER DR, GREENWOOD, IN 46143-8451

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001943A
IN

Other

Enumeration date
01/20/2015
Last updated
01/20/2015
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