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1972678969
GARY LARSON
SAINT PAUL, MN
NPI
1972678969
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2006-11-22
Last Update Date
2007-07-08
Business Address
-- GARY LARSON
180 GROTTO ST S
SAINT PAUL, MN 55105-3505
Phone number: 651-224-1395
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Mailing Address
-- GARY LARSON
4846 MOON LAKE CIR
SAINT PAUL, MN 55127-7049
Phone number:
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