Basic Information
| Provider Information | |||||||||
| NPI: | 1518287457 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANGER | ||||||||
| FirstName: | LARISSA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401W GLYNN DR | ||||||||
| Address2: | |||||||||
| City: | PARKSTON | ||||||||
| State: | SD | ||||||||
| PostalCode: | 573669605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6059287961 | ||||||||
| FaxNumber: | 6059287368 | ||||||||
| Practice Location | |||||||||
| Address1: | 123 S 27TH ST | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591014200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062473350 | ||||||||
| FaxNumber: | 4062473307 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2010 | ||||||||
| LastUpdateDate: | 10/12/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 9681 | SD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.