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General NPI Number Information
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NPI Number | 1942989462
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Entity Type | Individual
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Provider Name | BROOKE LARSON
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Gender | Female
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 2950 PROFESSIONAL PL STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80904-8106
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Country | US
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Telephone | 719-667-1327
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Fax |
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Provider Business Mailing Address
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Address Line | 5710 SNOW CREEK PT APT 105
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City | COLORADO SPRINGS
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State | CO
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Zip | 80915-5065
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Country | US
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Telephone | 785-443-0109
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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 |
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License Number State |
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