Individual
CONNOR ALAN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
811 S 10TH ST, WATERTOWN, WI 53094-4905
(920) 428-5998
Mailing address
811 S 10TH ST, WATERTOWN, WI 53094-4905
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/08/2019
Last updated
07/22/2021
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