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Individual
ANDREA ELIZABETH LARSON
Active
Individual
ANDREA ELIZABETH LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2022008365
MO
207Q00000X
Family Medicine Physician
Primary
60805
MN
208D00000X
General Practice Physician
60805
MN
Other
Enumeration date
06/03/2015
Last updated
10/09/2024
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