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Individual

DAVID C LARSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
311 ELM ST, WOODRUFF, WI 54568-9149
(715) 634-9023
(715) 634-9935
Mailing address
7428 LOON LANDING SHRS, LAKE TOMAHAWK, WI 54539-9110
(877) 265-5225
(715) 277-4944

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
737-25
WI
213ES0131X
Foot Surgery Podiatrist
737-25
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43222700
WI
01
CG4176
RAILROAD MEDICARE
WI
Enumeration date
09/23/2005
Last updated
08/23/2017
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