Larsen, Tyrel
Larsen, Tyrel is an individual health care provider with primary practice located at 3108 W Deyoung St Ste A , Marion IL 62959-5548. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is his primary health care specialty. Larsen, Tyrel can be contacted via phone (479) 254-0669.Contact Information
Primary practice address
3108 W Deyoung St Ste A
Marion IL 62959-5548
Phone: (479) 254-0669
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | DS035312 | Pennsylvania |
Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 021.003269 | Illinois |
Profile Details
NPI number | 1396366381 |
---|---|
LBN Legal business name | Larsen, Tyrel |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 30th, 2020 |
Last updated | Nov 15th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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