Individual
MOLLY M LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
650 MCMILLEN ST, FORT ATKINSON, WI 53538-1275
(920) 563-8900
Mailing address
650 MCMILLEN ST, FORT ATKINSON, WI 53538-1275
(920) 563-8900
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
52543
CO
207V00000X
Obstetrics & Gynecology Physician
Primary
74392-20
WI
Other
Enumeration date
06/16/2011
Last updated
10/07/2022
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