Individual
MR. RICHARD MARK LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
308 MISSION DR, ST IGNATIUS, MT 59065
(406) 745-3525
Mailing address
PO BOX 880, ST IGNATIUS, MT 59865
(406) 745-3525
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4500
MT
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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