Jill C. Larson, D.O.

NPI #1174612253 in Mukwonago, Wisconsin

Provider Information

NPI Number: 1174612253
Entity Type: Individual
Name: Jill C. Larson, D.O.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: D.O.
Enumeration Date: Oct 12, 2006
Last Updated: Nov 9, 2011

Practice Location

Address: 240 MAPLE AVE.
Address 2: PROHEALTH CARE MEDICAL ASSOCIATES, INC.
City: Mukwonago
State: Wisconsin
ZIP Code: 53149-8475
Phone: (262) 928-1900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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