Individual
DR. STANLEY GLENN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3898 W. 13400 SO., SUITE B., RIVERTON, UT 84065-6038
(801) 302-0660
(801) 302-2239
Mailing address
1566 E SEGO LILY DR, SANDY, UT 84092-4330
(307) 277-2354
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5052470-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5052470-1202
D.C.
UT
Enumeration date
08/16/2007
Last updated
08/18/2015
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