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Organization
MICHAEL CRAIG LARSEN AN OPTOMETRIC CORPORATION
Active
Organization
MICHAEL CRAIG LARSEN AN OPTOMETRIC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LARSEN OD (OWNER)
(801) 444-1411
Entity
Organization
Contact information
Practice address
461 SKYMASTER CIR, TRAVIS AFB, CA 94535-1909
(707) 437-4095
Mailing address
675 S 600 E, LAYTON, UT 84041-4278
(801) 444-1411
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11165
CA
Other
Enumeration date
09/21/2009
Last updated
09/21/2009
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