Tyrel Larsen
Tyrel Larsen is a Student in an Organized Health Care Education/Training Program in Marion, Illinois. Licensed in Illinois and Pennsylvania. Registered with an NPI since 2020.
- Licensed in
- IL, PA
- In the registry since
- 2020
- Specialties on file
- 2
Practice location Address checks out
3108 W Deyoung St Ste AMarion, IL 62959-5548
Phone: (479) 254-0669
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Orthodontics and Dentofacial Orthopedics Dentistry (primary) | Taxonomy 1223X0400X · Licence 021.003269 (IL) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X · Licence DS035312 (PA) |
Record details
| NPI number | 1396366381 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | April 30, 2020 |
| Last updated in NPPES | November 15, 2023 |
| Certification date | November 14, 2023 |
| Mailing address | 3108 W Deyoung St Ste A, Marion, IL 62959-5548 |
Other providers in Marion
-
Mrs. Liudmila Vasilets, MD
3111 Williamson County Pkwy, Marion, IL 62959-5235 · (618) 519-9200
-
Williamson Co Special Education District
411 S Court St, Marion, IL 62959-2711 · (618) 993-2138