Individual
AMY L LARSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2920 SUPERIOR AVE, SHEBOYGAN, WI 53081-1944
(920) 458-8707
(920) 452-6107
Mailing address
2920 SUPERIOR AVE, SHEBOYGAN, WI 53081-1944
(920) 458-8707
(920) 452-6107
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3142
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40161600
—
WI
Enumeration date
10/10/2005
Last updated
07/08/2007
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