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Organization
LARSEN ANESTHESIA PC
Active
Organization
LARSEN ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS LARSEN MD (PROVIDER/OWNER)
(307) 638-0300
Entity
Organization
Contact information
Practice address
3584 W 9000 S, WEST JORDAN, UT 84088-5710
(307) 638-0300
(307) 638-0394
Mailing address
PO BOX 20188, CHEYENNE, WY 82003-7004
(307) 638-0300
(307) 638-0394
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
76505701204
UT
Other
Enumeration date
06/12/2015
Last updated
06/12/2015
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