Larson, Jennifer L

Larson, Jennifer L is an sole proprietor health care provider with primary practice located at 1309 W Guadalupe Rd Suite 1, Mesa AZ 85202-9112. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Larson, Jennifer L can be contacted via phone (480) 280-9625.

Contact Information

Primary practice address
1309 W Guadalupe Rd Suite 1 Mesa AZ 85202-9112
Phone: (480) 280-9625
Fax: (480) 718-7628
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 9105PT Arizona
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X MT-11128 Arizona

Profile Details

NPI number 1952610412
LBN Legal business name Larson, Jennifer L
Credentials PT, DPT, LMT, CERTDN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 1st, 2010
Last updated Nov 6th, 2014 - about 12 years ago

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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1952610412 NPPES
Arizona MEDICAID 560177

Popular Providers