Madeline Lorraine Larson

NPI #1306514252 in Lakeville, Minnesota

Provider Information

NPI Number: 1306514252
Entity Type: Individual
Name: Madeline Lorraine Larson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician, Other
Enumeration Date: Sep 3, 2021
Last Updated: Sep 3, 2021

Practice Location

Address: 10450 185TH ST W STE 100
City: Lakeville
State: Minnesota
ZIP Code: 55044-6696
Phone: (612) 509-6690

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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