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NPI Code Detail

MEDICARE: XANDER DAVID LARSEN

MEDICARE: XANDER DAVID LARSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianUT

General Provider Information

NPI Number : 1356202709
Entity Type Code : Individual
Provider Name (Legal Business Name) : XANDER DAVID LARSEN
Provider Business Mailing Address
First Line : 6013 S REDWOOD RD
Second Line :
City : TAYLORSVILLE
State : UT
Zip : 84123-5220
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1858 W 5150 S
Second Line :
City : ROY
State : UT
Zip : 84067-3000
Country : US
Telephone Number : 801-255-5131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2025
Last Update Date : 01/13/2026

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Directions to “ XANDER DAVID LARSEN ” Practice Location

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