Individual
MRS. CARLA EBERT LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, PAS, CSCS
Contact information
Practice address
N91W15700 FALLS PKWY, MENOMONEE FALLS, WI 53051-2301
(262) 255-5700
Mailing address
108 W FRANSEE LN, SAUKVILLE, WI 53080-1714
(262) 370-4891
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
—
—
2255A2300X
Athletic Trainer
Primary
246-039
WI
Other
Enumeration date
03/09/2006
Last updated
12/11/2015
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