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1023738986
COLLIN LARSON
BOISE, ID
NPI
1023738986
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-8186)
Enumeration Date
2022-08-31
Last Update Date
2022-08-31
Business Address
COLLIN LARSON
3040 N FIVE MILE RD
BOISE, ID 83713-5234
Phone number: 208-939-0533
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Mailing Address
COLLIN LARSON
12072 W MCMILLAN RD
BOISE, ID 83713-2462
Phone number: 208-939-0533
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