Individual
JESSICA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
W3173 COUNTY ROAD PP, SHEBOYGAN FALLS, WI 53085-2533
(920) 287-2200
Mailing address
W3173 COUNTY ROAD PP, SHEBOYGAN FALLS, WI 53085-2533
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/17/2015
Last updated
05/18/2015
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