IndividualActive
Kyle Larson, IDMT
NPI 1619617289 · Independent Duty Medical Technicians · Moody Afb, GA
Provider details
- NPI number
- 1619617289
- Entity type
- Individual
- Primary specialty
- Independent Duty Medical TechniciansOther Service Providers
- Credential
- IDMT
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
3278 Mitchell Blvd
Moody Afb, GA 31699-1500
Phone: (229) 257-2778
Approximate (ZIP-level) locationGet directions
Mailing address
3278 Mitchell Blvd
Moody Afb, GA 31699-1500
Registry dates
- Enumerated
- 2022-03-31
- Last updated
- 2026-02-25
- Certified
- 2026-02-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.