Individual
JEANNE M LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD.
Contact information
Practice address
320 S ACCESS RD, RICE LAKE, WI 54868-8572
(715) 236-7414
Mailing address
320 HIGHWAY O, RICE LAKE, WI 54868
(715) 236-7414
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11722-40
WI
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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