Provider Demographics
NPI:1548715873
Name:LARSON, MARIA ANNE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ANNE
Last Name:LARSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3086 S DAHLIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7331
Mailing Address - Country:US
Mailing Address - Phone:303-875-6909
Mailing Address - Fax:
Practice Address - Street 1:13121 E 17TH AVE STE C234
Practice Address - Street 2:EDUCATION 2 SOUTH, 5TH FL
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2596
Practice Address - Country:US
Practice Address - Phone:303-875-6909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO142652251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics