JACOB LARSEN

TWIN FALLS, ID
NPI1558730291
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2015-09-23
Last Update Date2015-09-23
Business Address
-- JACOB LARSEN PA
775 POLE LINE RD W STE 103
TWIN FALLS, ID 83301-5819
Phone number: 480-620-2084
Mailing Address
-- JACOB LARSEN PA
680 SUNRISE BLVD
TWIN FALLS, ID 83301-7060
Phone number: 480-620-2084