SHANE R LARSON

LOGAN, UT
NPI1528018496
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: UT  342616-1205)
Enumeration Date2006-05-11
Last Update Date2007-07-08
Business Address
-- SHANE R LARSON M.D.
274 N MAIN ST
LOGAN, UT 84321-3915
Phone number: 435-753-1600
Mailing Address
-- SHANE R LARSON M.D.
274 N MAIN ST
LOGAN, UT 84321-3915
Phone number: 435-753-1600
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