Individual
BRANDON LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
501 S WINSTED ST, SPRING GREEN, WI 53588-9435
(608) 588-0208
Mailing address
4603 COUNTY ROAD F, BLUE MOUNDS, WI 53517-9606
(608) 963-3401
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
2795-19
WI
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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