Organization
ROBERT A LARSON OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ARIC LARSON O.D. (OWNER)
(815) 436-8955
Entity
Organization
Contact information
Practice address
15420 S RTE 59, PLAINFIELD, IL 60544-1984
(815) 436-8955
(815) 496-8745
Mailing address
15420 S RTE 59, PLAINFIELD, IL 60544-1984
(815) 436-8955
(815) 496-8745
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0142300001
PTAN
IL
Enumeration date
10/18/2007
Last updated
10/17/2008
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