CENTER FOR COLON AND RECTAL DISEASES PLC
Medical Practice at Dobson Rd, Mesa, AZ

License number
Arizona 12943
Category
Medical Practice
Type
Specialist
Owner
Name: DR. DAVID MICHAEL LARSON M.D.
Title: OWNER
Phone: (480) 964-0707
Address
Address
1500 S Dobson Rd SUITE 313, Mesa, AZ 85202
National Provider ID: 1124273032
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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THE CENTER FOR COLON AND RECTAL DISEASES, PLC

4050 E Huber, Mesa, AZ 85205

Status:
Inactive
Industry:
Medical Doctor's Office
Registration:
Aug 28, 2008
State ID:
P-1472487-0
Expiration:
Perpetual
Members:
David Larson (Manager), 4050 E Huber, Mesa, AZ 85205 (Physical),Larson Revocable Living Trust (Member), 4050 E Huber, Mesa, AZ 85205 (Physical)
Agent:
Hkc Agents Llc,1635 N Greenfield Rd #115, Mesa, AZ 85205 (Physical)

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