Individual
MR. MICHAEL JOHN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCHIS
Contact information
Practice address
15612 WINDROSE LANE, #200, HAYWARD, WI 54843
(715) 634-8736
Mailing address
15612 WINDROSE LANE, SUITE #200, HAYWARD, WI 54843
(715) 634-8736
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42839200
—
WI
Enumeration date
04/29/2008
Last updated
04/29/2008
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