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1902295561
MARCUS JOHN LARSON
GREENWOOD, IN
NPI
1902295561
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36001943A)
Enumeration Date
2015-01-20
Last Update Date
2015-01-20
Business Address
-- MARCUS JOHN LARSON ATC, LAT
1401 W COUNTY LINE RD
GREENWOOD, IN 46142-5195
Phone number: 317-496-1248
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Mailing Address
-- MARCUS JOHN LARSON ATC, LAT
3416 WINCHESTER DR
GREENWOOD, IN 46143-8451
Phone number:
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