Individual
DAVID E. LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9601 TOWNLINE RD, MINOCQUA, WI 54548-9099
(715) 358-1000
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
34
WI
363AM0700X
Medical Physician Assistant
028
WI
363AM0700X
Medical Physician Assistant
1077
AZ
Other
Enumeration date
12/22/2006
Last updated
06/07/2012
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