Dr. Bruce D Larsen, M.D.
Family Medicine in Farr West, UT. Individual provider (NPI-1).
NPI number1922189372
StatusActive
Last updated in NPPESJun 14, 2019
Details
- NPI
- 1922189372
- Entity type
- Individual (NPI-1)
- Name
- Dr. Bruce D Larsen
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 18, 2006
- Last updated
- Jun 14, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 49625291205 | UT | Yes |
Practice location
2850 N 2000 WFarr West, UT 84404-9219
Phone 801-377-5757
Mailing address
1055 N 500 WAttn: Credentialing
Provo, UT 84604
Phone 801-354-8225 · Fax 801-418-0941
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