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1912027772
KEITH LARSON
DETROIT, MI
NPI
1912027772
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: MI 5601002740)
Enumeration Date
2007-03-29
Last Update Date
2007-07-08
Business Address
KEITH LARSON PA-C
3901 BEAUBIEN ST
DETROIT, MI 48201-2119
Phone number: 313-745-5437
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Mailing Address
KEITH LARSON PA-C
3901 BEAUBIEN CHM DEPT OF CARDIOVASCULAR SURGERY
DETROIT, MI 48201
Phone number: 313-745-5538
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