GREGORY THOMAS LARSON

PULLMAN, WA
NPI1790974764
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy172V00000X Community Health Worker
(Licence: WA  MA00015575)
Enumeration Date2007-10-16
Last Update Date2007-10-16
Business Address
Mr. GREGORY THOMAS LARSON LMP
167 NE KAMIAKEN ST (MEZZANINE)
PULLMAN, WA 99163-2611
Phone number: 509-332-0555
Mailing Address
Mr. GREGORY THOMAS LARSON LMP
167 NE KAMIAKEN ST (MEZZANINE)
PULLMAN, WA 99163-2611
Phone number: 509-332-0555
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