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Lars Larson

NPI Registration Record

Provider / OrganizationNPIDate Certified
LARS LARSON14276523612020-11-22
Entity TypeIndividual
Provider Name Lars Larson CRNP
Practice Office Address701 PRINCETON AVE SW
BIRMINGHAM, AL US
Practice Office Telephone2057837970
Mailing Address1141 N SHADESVIEW TER
HOMEWOOD, AL 352096637 US
HPT Codes
CodeLicense NoState
363LA2100X PRIMARY1-153397 AL
OPI Codes

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