Individual
KENNETH G LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4580 STATE ST, GREEN ACRES PLAZA, SAGINAW, MI 48603-3803
(989) 799-0171
(989) 799-6500
Mailing address
540 1ST AVE, HALE, MI 48739-9158
(989) 473-3459
(989) 799-6500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002177
MI
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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