Tyler J Larson, DPT | |
3155 Channing Way Ste D, Idaho Falls, ID 83404-7534 | |
(208) 552-2700 | |
(208) 552-1533 |
Full Name | Tyler J Larson |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 9 Years |
Location | 3155 Channing Way Ste D, Idaho Falls, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346626652 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT-4158 (Idaho) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Three Rivers Physical Therapy Inc | 1153543632 | 2 |
Provider Name | Three Rivers Physical Therapy Inc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1811256860 PECOS PAC ID: 1153543632 Enrollment ID: O20141118001436 |
Mailing Address | Practice Location Address |
---|---|
Tyler J Larson, DPT 1560 S Carol St, Meridian, ID 83646-1839 Ph: (208) 288-1155 | Tyler J Larson, DPT 3155 Channing Way Ste D, Idaho Falls, ID 83404-7534 Ph: (208) 552-2700 |
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