Individual provider · NPI-1

David James Larson

Specialist/Technologist, Athletic Trainer · Lorain, OH

NPI number1104624410
StatusActive
Last updated in NPPESAug 30, 2025

Details

NPI
1104624410
Entity type
Individual (NPI-1)
Name
David James Larson
Sex
Male
Sole proprietor
No
Enumeration date
Mar 4, 2025
Certification date
Aug 30, 2025
Last updated
Aug 30, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer––Yes

Practice location

425 Concord Dr
Lorain, OH 44052-2503

Phone 440-320-3972

Mailing address

425 Concord Dr
Lorain, OH 44052-2503

Phone 440-320-3972

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