Individual
DAVID P LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1330 N SUPERIOR AVE, TOMAH, WI 54660-1130
(608) 372-4458
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2311
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38581400
—
WI
Enumeration date
06/24/2005
Last updated
01/21/2016
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