Individual
MADISSON MICHELLE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26536 COUNTY 9, BEMIDJI, MN 56601-5453
(218) 766-7344
Mailing address
26536 COUNTY 9, BEMIDJI, MN 56601-5453
(218) 766-7344
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/02/2019
Last updated
02/02/2019
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