Larson, Mary St. John
Larson, Mary St. John is an sole proprietor health care provider with primary practice located at 2301 Park Ave #209, Orange Park FL 32073-5565. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Larson, Mary St. John can be contacted via phone (904) 215-9923.Contact Information
Primary practice address
2301 Park Ave #209
Orange Park FL 32073-5565
Phone: (904) 215-9923
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MA 39861 | Florida |
Profile Details
| NPI number | 1043346687 |
|---|---|
| LBN Legal business name | Larson, Mary St. John |
| Credentials | LMT,CMTPT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 26th, 2007 |
| Last updated | Dec 5th, 2013 - about 11 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 | 1043346687 | NPPES |
| Florida | Other | C4073 | BCBSF |
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