Individual
ROBERT LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6592 49TH ST N, OAKDALE, MN 55128-2001
(763) 780-0075
Mailing address
6592 49TH ST N, OAKDALE, MN 55128-2001
(651) 770-0098
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
365777
MN
Other
Enumeration date
07/30/2014
Last updated
07/30/2014
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