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1093722860
JOHN NICHOLAS LARSON
CHICAGO, IL
NPI
1093722860
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: IL 036075497)
Enumeration Date
2006-08-02
Last Update Date
2007-07-08
Business Address
-- JOHN NICHOLAS LARSON D.O.
1901 W HARRISON ST
CHICAGO, IL 60612-3714
Phone number: 312-864-3825
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Mailing Address
-- JOHN NICHOLAS LARSON D.O.
633 S LAFLIN ST APT 2
CHICAGO, IL 60607-3177
Phone number:
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