BRANDON LEON LARSEN

POCATELLO, ID
NPI1215523337
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: ID  PA-1985)
Enumeration Date2020-12-13
Last Update Date2020-12-13
Business Address
Mr. BRANDON LEON LARSEN PA-C
396 YELLOWSTONE AVE
POCATELLO, ID 83201-4572
Phone number: 208-254-7733
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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