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Individual

MICHAEL R. LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147-000231
IL

Other

Enumeration date
09/26/2006
Last updated
08/13/2008
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