Individual
KENNETH S LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9600 S 1300 E, #308, SANDY, UT 84094-3766
(801) 501-5590
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 501-5590
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
932612681205
UT
Other
Enumeration date
09/07/2006
Last updated
10/20/2007
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