Individual
LARSON DAVICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
Mailing address
49725 COUNTY 83, STAPLES, MN 56479-5280
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MN
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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