Individual
BAILEY LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 W 26TH ST, SIOUX FALLS, SD 57105-2446
(605) 444-9532
Mailing address
2501 W 26TH ST, SIOUX FALLS, SD 57105-2446
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0718
SD BOARD OF OSTEOPATHIC AND MEDICAL EXAMINERS
SD
Enumeration date
06/21/2021
Last updated
06/21/2021
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