Individual
HAYDEN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5500 CLYDE PARK AVE SW, WYOMING, MI 49509-9525
(616) 532-3710
Mailing address
7767 AUSTINRIDGE DR SE, CALEDONIA, MI 49316-8915
(616) 826-2243
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005146
MI
Other
Enumeration date
07/14/2018
Last updated
07/14/2018
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