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1619520251
JOHN PAUL LARSON
FOND DU LAC, WI
NPI
1619520251
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 18138-130)
Enumeration Date
2019-07-23
Last Update Date
2019-07-23
Business Address
Mr. JOHN PAUL LARSON SAC-IT
430 E DIVISION ST
FOND DU LAC, WI 54935-4560
Phone number: 920-926-4172
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Mailing Address
Mr. JOHN PAUL LARSON SAC-IT
430 E DIVISION ST
FOND DU LAC, WI 54935-4560
Phone number: 920-926-4172
Copy
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