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Individual

STEVEN WAYNE LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
27 MAIN ST, SHERBURN, MN 56171
(507) 764-4080
(507) 764-4081
Mailing address
PO BOX 557, SHERBURN, MN 56171-0557
(507) 764-4080
(507) 764-4081

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4485
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
387R8SH
BLUE CROSS BLUE SHIELD
MN
Enumeration date
10/17/2006
Last updated
10/08/2007
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