Individual provider · Type 1 NPI

Brandon Leon Larsen, PA-C

Medical Physician Assistant · Idaho Falls, ID

NPI number 1215523337 Active

Practice location

1301 E 17th St
Idaho Falls, ID 83404-6273

Call (208) 991-4296 Map

Fax (208) 656-2846

Mailing address

891 Tie Breaker Dr
Ammon, ID 83406-4554

Other practice locations

  • 3760 Washington Pkwy, Idaho Falls, ID 83404-7593 · (208) 881-5779

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA-1985 (ID)

Medical Physician Assistant: Definition to come...

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About NPI 1215523337

Brandon Leon Larsen, PA-C's National Provider Identifier is 1215523337, issued on Dec 13, 2020. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Idaho Falls, ID. The record was last updated on Nov 19, 2024.