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General NPI Number Information
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NPI Number | 1093747727
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Entity Type | Individual
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Provider Name | ELIZABETH FRANCES LARSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 08/17/2012
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Provider Practice Location Address
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Address Line | 81 OLD COLONY WAY STE D
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City | ORLEANS
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State | MA
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Zip | 02653-3278
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Country | US
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Telephone | 508-240-1141
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Fax | 508-240-3031
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Provider Business Mailing Address
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Address Line | 81 OLD COLONY WAY STE D
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City | ORLEANS
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State | MA
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Zip | 02653-3278
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Country | US
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Telephone | 508-240-1141
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Fax | 508-240-3031
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1114
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License Number State | MA
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