Tyler Roth Larson, PA-C
NPI #1003211103 in Sweet Home, Oregon
Provider Information
- NPI Number
- 1003211103
- Entity Type
- Individual
- Name
- Tyler Roth Larson, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Oct 31, 2014
- Last Updated
- Nov 27, 2023
Practice Location
- Address
- 1289 49TH AVE
- City
- Sweet Home
- State
- Oregon
- ZIP Code
- 97386
- Phone
- (541) 451-6250
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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