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1487606679
JOHN JEFFREY LARSON
MILWAUKEE, WI
NPI
1487606679
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI 205-039)
Enumeration Date
2006-05-16
Last Update Date
2007-07-08
Business Address
Mr. JOHN JEFFREY LARSON LAT, ATC,CSCS
6701 N JEAN NICOLET RD
MILWAUKEE, WI 53217-3701
Phone number: 414-351-8154
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Mailing Address
Mr. JOHN JEFFREY LARSON LAT, ATC,CSCS
108 W FRANSEE LN
SAUKVILLE, WI 53080-1714
Phone number: 262-268-9869
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