Individual
MICHAEL LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2639 NEW PINERY RD STE 2, PORTAGE, WI 53901-1175
(608) 742-9356
(608) 742-9358
Mailing address
2639 NEW PINERY RD STE 2, PORTAGE, WI 53901-1175
(608) 742-9356
(608) 742-9358
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17625-24
WI
Other
Enumeration date
03/03/2026
Last updated
03/03/2026
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