Individual
MRS. LISA ANN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
901 BROADWATER SQ, BILLINGS, MT 59101-1634
(406) 259-4393
(406) 896-1245
Mailing address
901 BROADWATER SQ, BILLINGS, MT 59101-1634
(406) 259-4393
(406) 896-1245
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
676
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-01157-3
STATE FUND
MT
01
—
40251
BLUE CROSS BLUE SHIELD
MT
Enumeration date
12/19/2006
Last updated
07/08/2015
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