Larson, Karla Marie

Larson, Karla Marie is an individual health care provider with primary practice located at 729 Park St , Antigo WI 54409-2745. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Larson, Karla Marie can be contacted via phone (715) 623-2356.

Contact Information

Primary practice address
729 Park St Antigo WI 54409-2745
Fax:
Website:

Health care specialties

Profile Details

NPI number 1376717264
LBN Legal business name Larson, Karla Marie
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2008
Last updated Apr 22nd, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376717264 NPPES
Wisconsin Other 1952-024 WI PROFESSIONAL PT LICENSE
Wisconsin MEDICAID 40020100 WI PROFESSIONAL PT LICENSE

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