Individual
MATTHEW CRAIG LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1650 COCHRANE CIRCLE, 1CU USA MEDDAC EVANS ARMY COMMUNITY HOSPITAL, FORT CARSON, CO 80913-4604
(719) 526-7020
(719) 526-7635
Mailing address
1650 COCHRANE CIRCLE, DEPARTMENT OF THE ARMY USA MEDDAC EVANS ARMY COMMUNITY, FORT CARSON, CO 80913-4606
(719) 526-7649
(719) 526-7019
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
20219
NE
164W00000X
Licensed Practical Nurse
Primary
44156
CO
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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