Individual
JOYCE L LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
506 1ST AVE SE, WATERTOWN, SD 57201-4402
(605) 886-8482
(605) 884-4300
Mailing address
506 1ST AVE SE, WATERTOWN, SD 57201-4402
(605) 886-8482
(605) 884-4300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
1019
SD
363AM0700X
Medical Physician Assistant
Primary
9179
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182785500
—
MN
Enumeration date
06/21/2006
Last updated
10/31/2016
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