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Individual

DENISE MARIE LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
301 HIGHWAY 65 S, FIRSTLIGHT HEALTH SYSTEM, MORA, MN 55051-1899
(320) 225-3432
Mailing address
301 HIGHWAY 65 S, FIRSTLIGHT HEALTH SYSTEM, MORA, MN 55051-1899
(320) 225-3432

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
36489
MN
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
36489
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
302513600
MN
Enumeration date
06/28/2006
Last updated
04/22/2016
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