Individual
ANDREA LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17370 LAKESIDE HILLS PLZ, OMAHA, NE 68130-2352
(402) 333-5351
(402) 333-5499
Mailing address
17370 LAKESIDE HILLS PLZ, OMAHA, NE 68130-2352
(402) 333-5351
(402) 333-5499
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12895
NE
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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