# RIVERTOWN MEDICAL CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447985171
- **Authorized official:** DR. DANIEL LARSEN DC (CEO)
- **Authorized official phone:** (651) 439-2712

## Contact information

- **Practice address:** 5630 MEMORIAL AVE N STE 1, STILLWATER, MN 55082-1087
- **Practice address phone:** (651) 439-2712
- **Practice address fax:** (651) 439-2663
- **Mailing address:** 5630 MEMORIAL AVE N STE 1, STILLWATER, MN 55082-1087
- **Mailing address phone:** (651) 439-2712
- **Mailing address fax:** (651) 439-2663

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 202D00000X | Integrative Medicine Physician | — | NULL | Yes |
| 202D00000X | Integrative Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/18/2022
- **Last updated:** 07/18/2022