Individual
NICOLE MARIE LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC, M.OM
Contact information
Practice address
200 W 96TH ST APT 2B, BLOOMINGTON, MN 55420-4328
(651) 214-1428
Mailing address
200 WEST 96TH, APT #2B, BLOOMINGTON, MN 55420-5542
(651) 214-1428
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1378
MN
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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