| Doctor Name: | MARC SHAW LARSON |
| NPI Number: | 1093939761 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 33089 |
| Business Practice Address: | 1030 Medical Dr Brigham City, UT - 843023050 |
| Business Phone Number: | 4355385111 |
| Business Fax Number: | |
| Mailing Address: | Po Box 739, BRIGHAM CITY |
| State: | UT |
| Postal Code: | 843020739 |
| Phone Number: | 7148513483 |
| Fax Number: | |
| NPI Enumeration Date: | 04/12/2007 |
| NPI Last Update Date: | 12/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 33089 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |