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General NPI Number Information
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NPI Number | 1154735728
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Entity Type | Individual
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Provider Name | LARSON STAIR
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Gender | Male
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Dates
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Enumeration Date | 06/11/2014
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Last Update Date | 06/11/2014
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Provider Practice Location Address
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Address Line | 6702 W COAL MINE AVE
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City | LITTLETON
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State | CO
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Zip | 80123-4573
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Country | US
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Telephone | 720-283-2082
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Fax |
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Provider Business Mailing Address
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Address Line | 215 SHUMAN BLVD STE. 401
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City | NAPERVILLE
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State | IL
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Zip | 60563-8458
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Country | US
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Telephone | 630-303-5380
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Fax | 978-313-6824
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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