Individual
DR. BRUCE L LARVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3434 CELINA AVE, SAINT JOSEPH, MI 49085-3711
(269) 429-7225
Mailing address
1901 NILES AVE, SUITE 101, SAINT JOSEPH, MI 49085-1615
(269) 983-0929
(269) 983-0929
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301038611
MI
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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