| Doctor Name: | STEVEN ALLEN LARSEN |
| NPI Number: | 1508953555 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | M-9927 |
| Business Practice Address: | 1151 Hospital Way Bldg B Pocatello, ID - 832015091 |
| Business Phone Number: | 2082331187 |
| Business Fax Number: | 2082343841 |
| Mailing Address: | 1151 Hospital Way, Bldg B POCATELLO |
| State: | ID |
| Postal Code: | 832015091 |
| Phone Number: | 2082331187 |
| Fax Number: | 2082333841 |
| NPI Enumeration Date: | 10/09/2006 |
| NPI Last Update Date: | 08/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | M-9927 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |