Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2852 | NE |
NPI | 1003101734 |
---|---|
Provider Name | Alison Helen Larsen |
First Address | Omaha, NE 68134-6100 |
Second Address | Omaha, NE 68134-6100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2011 |
Last Update Date | 10/06/2011 |