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1124882782
JORDAN LARSSON
SACRAMENTO, CA
NPI
1124882782
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-02-13
Last Update Date
2024-02-13
Business Address
JORDAN LARSSON
4610 X ST
SACRAMENTO, CA 95817-2200
Phone number: 209-717-9628
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Mailing Address
JORDAN LARSSON
4610 X ST
SACRAMENTO, CA 95817-2200
Phone number: 209-717-9628
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