Individual
DR. JERROLD L LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1940 E 1ST ST, CASPER, WY 82601-2747
(307) 266-9988
(307) 266-9992
Mailing address
1940 E 1ST ST, CASPER, WY 82601-2747
(307) 266-9988
(307) 266-9992
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
157T
WY
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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