Larson, Jodie S
Larson, Jodie S is an individual health care provider with primary practice located at 302 N Harth Ave , Madison SD 57042-2219. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Larson, Jodie S can be contacted via phone (605) 256-6911.Contact Information
Primary practice address
302 N Harth Ave
Madison SD 57042-2219
Phone: (605) 256-6911
Fax: (605) 256-9017
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 619 | South Dakota |
Profile Details
| NPI number | 1417942251 |
|---|---|
| LBN Legal business name | Larson, Jodie S |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Oct 9th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417942251 | NPPES |
| Minnesota | MEDICAID | 865819600 | |
| Minnesota | MEDICAID | 9203640 |
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