Individual
JEFFREY LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1516 E SAINT PATRICK ST, RAPID CITY, SD 57703-4136
(605) 343-6214
(605) 343-5212
Mailing address
1516 E SAINT PATRICK ST, RAPID CITY, SD 57703-4136
(605) 343-6214
(605) 343-5212
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4503
SD
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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