Individual
KIMBERLY LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19772 160TH ST N, BORUP, MN 56519-9660
(701) 541-7220
Mailing address
19772 160TH ST N, BORUP, MN 56519-9660
(701) 541-7220
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
1112157
MN
Other
Enumeration date
11/18/2022
Last updated
11/18/2022
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