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Organization
ORTHOPEDIC SURGICAL CONSULTANTS, P.A.
Active
Organization
ORTHOPEDIC SURGICAL CONSULTANTS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER R. LARSON PA-C (OFFICE MANGER)
(952) 403-3399
Entity
Organization
Contact information
Practice address
1515 SAINT FRANCIS AVE, SUITE 150, SHAKOPEE, MN 55379-3387
(952) 403-3399
(952) 403-3390
Mailing address
1515 SAINT FRANCIS AVE, SUITE 150, SHAKOPEE, MN 55379-3387
(952) 403-3399
(952) 403-3390
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
826312400
—
MN
Enumeration date
05/25/2006
Last updated
05/21/2010
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