Brian J Larson CNIM

NPI 1083836639 - Specialist/Technologist, Other - 246ZE0600X

NPI Details
NPI 1083836639
Gender Male
Enumeration Date 05/03/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
905 W ST ANTHONY AVE
EFFINGHAM IL, 62401, US
Phone (217) 342-7256
Fax
Business Location
PO BOX 1527
EFFINGHAM IL, 62401-1527, US
Phone (217) 342-7256
Fax
Toxanomy
Taxonomy Code 246ZE0600X
License State
License Number
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According to our database, Brian J Larson CNIM NPI is 1083836639, taxonomy code is 246ZE0600X Brian J Larson CNIM physically located at 905 W St Anthony Ave, Effingham IL, 62401. NPI Number Brian J Larson CNIM has the Individual type.

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1083836639 NPI number is provided on an as is basis without warranty of any kind. 1083836639 is maintained by the National Plan & Provider Enumeration System. The contents of Brian J Larson CNIM are for informational purposes only.