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Individual

LARISSA N WILHELM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
20 UNION ST N, MORA, MN 55051-1326
(320) 679-8996
Mailing address
509 W WISCONSIN AVE, GRANTSBURG, WI 54840-7823

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6886
MN

Other

Enumeration date
09/01/2021
Last updated
09/01/2021
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