Organization
L CRAIG LARSEN DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. L CLARK LARSEN DPM (PRESIDENT)
(801) 261-1391
Entity
Organization
Contact information
Practice address
5801 FASHION BLVD, # 120, MURRAY, UT 84107-6159
(801) 261-1391
(801) 261-1394
Mailing address
5801 FASHION BLVD, # 120, MURRAY, UT 84107-6159
(801) 261-1391
(801) 261-1394
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
101447-0501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529501253006
—
UT
Enumeration date
03/17/2006
Last updated
12/01/2014
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