Larson, Andrew Jon

Larson, Andrew Jon is an individual health care provider with primary practice located at 9900 13Th Avenue North Suite 2A, Plymouth MN 55441-5035. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatopathology, which is considered as his primary health care specialty. Larson, Andrew Jon can be contacted via phone (763) 525-0363.

Contact Information

Primary practice address
9900 13Th Avenue North Suite 2A Plymouth MN 55441-5035
Phone: (763) 525-0363
Fax: (763) 525-0369
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ZD0900X 02003283A Indiana

Profile Details

NPI number 1528296043
LBN Legal business name Larson, Andrew Jon
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2009
Last updated Oct 17th, 2014 - about 12 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 1528296043 NPPES
Indiana Other 02003283A INDIANA PROFESSIONAL LICENSING AGENCY

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