Individual
DR. VIKTORIA LARSON DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
18 BENZEL AVE NW, MADELIA, MN 56062-1422
(507) 642-3853
Mailing address
PO BOX 190, MADELIA, MN 56062-0190
(507) 642-3853
(507) 642-3854
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2730
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136600900
—
MN
01
—
288R1DA
BLUE CROSS BLUE SHIELD OF MN
MN
Enumeration date
06/16/2005
Last updated
01/16/2025
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