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General NPI Number Information
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NPI Number | 1831197532
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Entity Type | Individual
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Provider Name | WILLIAM J LARSEN AU.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 1242 HOCKMAN PIKE
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City | BLUEFIELD
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State | VA
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Zip | 24605-9351
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Country | US
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Telephone | 276-326-3890
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Fax |
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Provider Business Mailing Address
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Address Line | 1242 HOCKMAN PIKE
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City | BLUEFIELD
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State | VA
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Zip | 24605-9351
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Country | US
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Telephone | 276-326-3890
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Fax |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 2201000378
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License Number State | VA
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