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1073053518
PETER LARSON
MERIDIAN, ID
NPI
1073053518
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: ID 55261)
Enumeration Date
2017-03-02
Last Update Date
2021-12-06
Business Address
PETER LARSON NP-C
3525 E LOUISE DR STE 400
MERIDIAN, ID 83642-6303
Phone number: 208-322-1680
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Mailing Address
PETER LARSON NP-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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