Individual
MARK R LAROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
424 W STATE HIGHWAY 5, WACONIA, MN 55387-1723
(952) 442-4461
(952) 442-4419
Mailing address
424 W STATE HIGHWAY 5, WACONIA, MN 55387-1723
(952) 442-4461
(952) 442-4419
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
41390
MN
Other
Enumeration date
11/03/2006
Last updated
08/15/2012
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