Organization
KEITH LARSON NEUROLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH DARRYL LARSON M.D. (PRESIDENT)
(320) 217-8880
Entity
Organization
Contact information
Practice address
1511 NORTHWAY DR, SUITE 202, SAINT CLOUD, MN 56303-1261
(320) 217-8880
(320) 253-1822
Mailing address
1511 NORTHWAY DR, SUITE 202, SAINT CLOUD, MN 56303-1261
(320) 217-8880
(320) 253-1822
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
22693
MN
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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