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1215523337
BRANDON LEON LARSEN
IDAHO FALLS, ID
NPI
1215523337
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA-1985)
Enumeration Date
2020-12-13
Last Update Date
2024-11-19
Business Address
Mr. BRANDON LEON LARSEN PA-C
1301 E 17TH ST
IDAHO FALLS, ID 83404-6273
Phone number: 208-991-4296
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Mailing Address
Mr. BRANDON LEON LARSEN PA-C
891 TIE BREAKER DR
AMMON, ID 83406-4554
Phone number: 208-569-8676
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