Larsen, Daniel

Larsen, Daniel is an individual health care provider with primary practice located at 700 W Kent Ave , Missoula MT 59801-6772. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Larsen, Daniel can be contacted via phone (406) 541-3937.

Contact Information

Primary practice address
700 W Kent Ave Missoula MT 59801-6772
Phone: (406) 541-3937
Fax: (406) 541-1810
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 581 Montana

Profile Details

NPI number 1649265919
LBN Legal business name Larsen, Daniel
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Apr 14th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649265919 NPPES
Montana MEDICAID 0480964
Montana MEDICAID 807213000

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