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Contact Information

BRANDON LARSON, PTA
501 S WINSTED ST
SPRING GREEN, WI53588-9435
 Phone: 608-588-0208
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatrics

2251G0304X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for BRANDON LARSON · (Male)

NPI # 1639648082
Status Active
Credentials PTA (Physical Therapist Assistant)
Entity Individual
Enumeration date 11/15/2018
Last updated 11/15/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 2795-19
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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