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Individual

CONNOR LAROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1901 W LUGONIA AVE, SUITE 230, REDLANDS, CA 92374-9703
(909) 557-1600
Mailing address
2301 ERWIN RD, DURHAM, NC 27710-0001
(919) 970-7363

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
A111430
CA
390200000X
Student in an Organized Health Care Education/Training Program
AD3189380-CL19
NC

Other

Enumeration date
05/20/2008
Last updated
03/14/2012
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