Most Relevant Information
Provider Data
| NPI Number: | 1003280082 |
| Provider Name: | DAVID VERNON LARSON PHARMACIST |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 009242 |
Most Important Dates
| Enumeration Date: | 11/13/2015 |
| Last Updated: | 11/13/2015 |
Provider Practice Location
31236 N TRAIL DUST DR
SAN TAN VALLEY
AZ
851434139
Practice Location Phone/Fax
| Phone: | 4804591739 |
| Fax: | 4804571089 |
Provider Mailing Location
31236 N TRAIL DUST DR
SAN TAN VALLEY
AZ
851434139
Provider Mailing Phone/Fax
| Phone: | 4804591739 |
| Fax: | 4804571089 |