Individual
BRETT ROBERT LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3903 HARRISON BLVD, 100, OGDEN, UT 84403-2361
(801) 387-7466
Mailing address
3903 HARRISON BLVD, 100, OGDEN, UT 84403-2361
(801) 387-7466
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
12220359-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
12220359-1205
UT
Other
Enumeration date
03/31/2016
Last updated
08/28/2023
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