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Individual

CHRISTINE LEEANN LARSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
9801 DUPONT AVE S, BLOOMINGTON, MN 55431-3100
(952) 888-5800
Mailing address
9801 DUPONT AVE S, BLOOMINGTON, MN 55431-3100

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
56362
MN
207W00000X
Ophthalmology Physician
56846-20
WI

Other

Enumeration date
06/25/2008
Last updated
06/18/2013
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