Individual
NICOLE K LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HIS
Contact information
Practice address
800 N KELLER DR, EFFINGHAM, IL 62401-1739
(217) 347-5934
(217) 347-5939
Mailing address
233 N MAIN ST STE 3, DECATUR, IL 62523-1208
(217) 875-5555
(217) 875-9640
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3359
IL
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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