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1336599224
PAUL LARSON
BEAVER DAM, WI
NPI
1336599224
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WI 13114-24)
Enumeration Date
2016-06-21
Last Update Date
2016-06-21
Business Address
Mr. PAUL LARSON DPT
803 S UNIVERSITY AVE
BEAVER DAM, WI 53916-3029
Phone number: 920-887-4039
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Mailing Address
Mr. PAUL LARSON DPT
803 S UNIVERSITY AVE
BEAVER DAM, WI 53916-3029
Phone number: 920-887-4039
Copy
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