Individual
GRANT LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-3922
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
67499
MN
Other
Enumeration date
03/30/2017
Last updated
05/21/2023
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