Larson, Alan
Larson, Alan is an individual health care provider with primary practice located at 733 Marquette Ave Suite 219, Minneapolis MN 55402-2309. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Larson, Alan can be contacted via phone (612) 332-6656.Contact Information
Primary practice address
733 Marquette Ave Suite 219
Minneapolis MN 55402-2309
Phone: (612) 332-6656
Fax: (612) 904-2438
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1901 | Minnesota |
Profile Details
| NPI number | 1073677506 |
|---|---|
| LBN Legal business name | Larson, Alan |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 20th, 2006 |
| Last updated | Apr 3rd, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073677506 | NPPES |
| Minnesota | MEDICAID | 468723000 |
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