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1285998146
THOMAS LARSEN
SOUTH BEND, IN
NPI
1285998146
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 01075173A)
Enumeration Date
2012-06-26
Last Update Date
2015-09-09
Business Address
-- THOMAS LARSEN MD
4440 PORTAGE AVE
SOUTH BEND, IN 46628-9570
Phone number: 574-204-6200
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Mailing Address
-- THOMAS LARSEN MD
4440 PORTAGE AVE
SOUTH BEND, IN 46628-9570
Phone number: 574-204-6200
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