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1831496496
CODY LARSON
WAHIAWA, HI
NPI
1831496496
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2011-02-17
Last Update Date
2011-02-17
Business Address
-- CODY LARSON PAC
677 MCCORNACK RD
WAHIAWA, HI 96786
Phone number: 808-354-8185
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Mailing Address
-- CODY LARSON PAC
92-104 WAIALII PL APT O-1021
KAPOLEI, HI 96707-4425
Phone number: 808-354-8185
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