Individual
LIANA MIRANDA LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-8500
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17186-24
WI
Other
Enumeration date
05/27/2025
Last updated
05/27/2025
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