BRANDON JOHN LARSON

PUEBLO, CO
NPI1841746336
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: CO  PSLP.0000174)
Enumeration Date2016-08-25
Last Update Date2022-07-21
Business Address
-- BRANDON JOHN LARSON
1610 SCRANTON AVE # 81004
PUEBLO, CO 81004-2676
Phone number: 719-404-1000
Mailing Address
-- BRANDON JOHN LARSON
1610 SCRANTON AVE
PUEBLO, CO 81004-2676
Phone number: 719-404-1000
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