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Individual

DR. RICHARD THOMAS LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2198 EASTRIDGE CTR, EAU CLAIRE, WI 54701-3403
(715) 833-8050
Mailing address
2198 EASTRIDGE CTR, EAU CLAIRE, WI 54701-3403
(715) 833-8050

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1367
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38830200
WI
Enumeration date
01/29/2007
Last updated
07/08/2007
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