Individual
MR. KEITH WILLIAM LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3300 OAKDALE AVE N, ROBBINSDALE, MN 55422-2926
(763) 581-3980
(763) 581-3591
Mailing address
1529 IVORY CT, LAKE ELMO, MN 55042-9311
(651) 646-3091
(651) 646-3124
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1049989
MN
Other
Enumeration date
04/03/2006
Last updated
06/06/2019
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