NPI 1235730292

Michael Larson

Practitioner Pharmacist Montgomery, IL

Practice location

Address: 2000 Orchard Rd, Montgomery, IL 60538-1028
Phone: (630) 844-3509
Fax: (630) 844-3512

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 051026221 (IL)

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Registry record

NPI: 1235730292
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Nov 2020
Record last updated: 5 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.