Individual
MARK DANIEL LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4600 W LOOMIS RD STE 310, GREENFIELD, WI 53220-4858
(414) 281-0424
(414) 281-0959
Mailing address
4600 W LOOMIS RD STE 310, GREENFIELD, WI 53220-4858
(414) 281-0424
(414) 281-0959
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
73841
MN
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
84144-20
WI
Other
Enumeration date
03/31/2019
Last updated
09/10/2024
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