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John Dylan Larson

Student in an Organized Health Care Education/Training Program in Atlanta, GA. Individual provider (NPI-1).

NPI number1437671237
StatusActive
Last updated in NPPESJul 13, 2017

Details

NPI
1437671237
Entity type
Individual (NPI-1)
Name
John Dylan Larson
Sex
Male
Sole proprietor
No
Enumeration date
Jul 13, 2017
Last updated
Jul 13, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

100 Woodruff Cir Ne
Atlanta, GA 30322-1020

Phone 140-472-7845 · Fax 404-727-8454

Mailing address

550 John Wesley Dobbs Ave Ne Apt B
Atlanta, GA 30312-1700

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