Brett C Larsen, PA

NPI #1639367337 in Roosevelt, Utah

Provider Information

NPI Number: 1639367337
Entity Type: Individual
Name: Brett C Larsen, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Oct 9, 2007
Last Updated: Mar 13, 2008

Practice Location

Address: 210 W 300 N
Address 2: 75-3
City: Roosevelt
State: Utah
ZIP Code: 84066-2336
Phone: (435) 722-3971

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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