Individual
JOHN P LARSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1531 S MADISON ST, APPLETON, WI 54915-1800
(920) 996-3700
Mailing address
1531 S MADISON ST, APPLETON, WI 54915-1800
(920) 996-3700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6297024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40338300
—
WI
Enumeration date
09/28/2005
Last updated
07/08/2007
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