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Individual

ROSS ALAN LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM D

Contact information

Practice address
849 WOODWARD AVE, CHIPPEWA FALLS, WI 54729-3362
(715) 726-8540
(715) 720-0264
Mailing address
4272 119TH ST, CHIPPEWA FALLS, WI 54729-5677
(715) 861-3158

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13956-040
WI

Other

Enumeration date
01/20/2007
Last updated
07/08/2007
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