Individual
VICKI L LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCTMB
Contact information
Practice address
410 N RIVER ST, SPOONER, WI 54801-1495
(715) 635-9307
Mailing address
410 N RIVER ST, SPOONER, WI 54801-1495
(715) 635-9307
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4173046
WI
Other
Enumeration date
04/22/2008
Last updated
04/22/2008
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