Individual
EVAN CARL SWAGGERT LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1720 BASSETT DR, MANKATO, MN 56001-6569
(507) 682-7100
Mailing address
1720 BASSETT DR, MANKATO, MN 56001-6569
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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