Tucker Lloyd Larsen, PA-C

NPI #1245671379 in Plummer, Idaho

Provider Information

NPI Number: 1245671379
Entity Type: Individual
Name: Tucker Lloyd Larsen, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jul 17, 2013
Last Updated: Dec 8, 2016

Practice Location

Address: 427 N 12TH ST.
City: Plummer
State: Idaho
ZIP Code: 83851
Phone: (208) 686-1931

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Physician Assistant	363A00000X	Primary
Student in an Organized Health Care Education/Training Program	390200000X

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