Michael Larson

NPI #1235730292 in Montgomery, Illinois

Provider Information

NPI Number: 1235730292
Entity Type: Individual
Name: Michael Larson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Nov 5, 2020
Last Updated: Nov 5, 2020

Practice Location

Address: 2000 ORCHARD RD
City: Montgomery
State: Illinois
ZIP Code: 60538-1028
Phone: (630) 844-3509

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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