Larson, Mary Jo
Larson, Mary Jo is an individual health care provider with primary practice located at 510 8Th Ave Ne , Hazen ND 58545-4637. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Larson, Mary Jo can be contacted via phone (701) 748-2225.Contact Information
Primary practice address
510 8Th Ave Ne
Hazen ND 58545-4637
Phone: (701) 748-2225
Fax: (701) 748-5757
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 235 | North Dakota |
Profile Details
| NPI number | 1821206475 |
|---|---|
| LBN Legal business name | Larson, Mary Jo |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821206475 | NPPES |
| North Dakota | Other | 25572 | BCBS NUMBER |
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