Organization
MINNESOTA OTOLARYNGOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LARSEN M.D. (CEO)
(952) 925-5626
Entity
Organization
Contact information
Practice address
675 WATER ST, EXCELSIOR, MN 55331-3063
(952) 925-5626
Mailing address
675 WATER ST, EXCELSIOR, MN 55331-3063
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0202219
MN
Other
Enumeration date
01/29/2007
Last updated
08/22/2020
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