Tiffany L Larson, OT

NPI #1063596559 in West Bend, Wisconsin

Provider Information

NPI Number: 1063596559
Entity Type: Individual
Name: Tiffany L Larson, OT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: OT
Enumeration Date: Oct 24, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1190 E PARADISE DR
City: West Bend
State: Wisconsin
ZIP Code: 53095-5444
Phone: (262) 306-6319

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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