Larsen, David P
Larsen, David P is an individual health care provider with primary practice located at 1330 N Superior Ave , Tomah WI 54660-1130. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Larsen, David P can be contacted via phone (608) 372-4458.Contact Information
Primary practice address
1330 N Superior Ave
Tomah WI 54660-1130
Phone: (608) 372-4458
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2311 | Wisconsin |
Profile Details
| NPI number | 1417953308 |
|---|---|
| LBN Legal business name | Larsen, David P |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2005 |
| Last updated | Jan 21st, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417953308 | NPPES |
| Wisconsin | MEDICAID | 38581400 |
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