Individual
THAD PETER LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
612 S SIBLEY AVE, LITCHFIELD, MN 55355-3340
(320) 693-3242
Mailing address
24967 545TH AVE, GROVE CITY, MN 56243-5603
(801) 836-8423
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R200065-5
MN
Other
Enumeration date
04/26/2011
Last updated
05/09/2011
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