Individual
BRYAN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7220 MOUNT RUSHMORE RD, RAPID CITY, SD 57702-8754
(715) 236-8100
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
11638
SD
207X00000X
Orthopaedic Surgery Physician
Primary
42688-20
WI
Other
Enumeration date
09/26/2006
Last updated
05/14/2021
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