Individual
LARISSA ANN HAUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4 N PARK ST, NORTHWOOD, ND 58267-4102
(701) 587-6900
(701) 587-6109
Mailing address
4 N PARK ST, NORTHWOOD, ND 58267-4102
(701) 587-6900
(701) 587-6109
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0729
ND
Other
Enumeration date
07/02/2018
Last updated
01/17/2023
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