DR. Shane Lyle Larson, M.D.
NPI #1750601191 in Fort Eustis, Virginia
Provider Information
- NPI Number
- 1750601191
- Entity Type
- Individual
- Name
- DR. Shane Lyle Larson, M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Family Medicine - Sports Medicine
- Credential
- M.D.
- Enumeration Date
- Jun 8, 2010
- Last Updated
- Apr 27, 2022
Practice Location
- Address
- 576 JEFFERSON AVE
- City
- Fort Eustis
- State
- Virginia
- ZIP Code
- 23604-1373
- Phone
- (757) 820-1043
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Family Medicine - Sports Medicine — Sports Medicine |
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