| Kyle Anthony Larson, DPT | |
|
417 3rd Avenue, Clear Lake, WI 54005-8905 | |
| (715) 263-4103 | |
| (715) 263-4110 |
| Full Name | Kyle Anthony Larson |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 6 Years |
| Location | 417 3rd Avenue, Clear Lake, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245853175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 14996-24 (Wisconsin) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Clear Lake Physical Therapy And Rehab Specialists Llc | 0749327526 | 4 |
| Provider Name | Clear Lake Physical Therapy And Rehab Specialists Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1083845754 PECOS PAC ID: 0749327526 Enrollment ID: O20091027000797 |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle Anthony Larson, DPT Po Box 147, Clear Lake, WI 54005-0147 Ph: (715) 263-4103 | Kyle Anthony Larson, DPT 417 3rd Avenue, Clear Lake, WI 54005-8905 Ph: (715) 263-4103 |
Clear Lake Physical Therapy And Rehab Specialists Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 417 3rd Ave, Clear Lake, WI 54005 Phone: 715-263-4103 Fax: 866-245-8064 | |
Emily J Monson, MSPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 417 3rd Ave, Clear Lake, WI 54005 Phone: 715-263-4103 Fax: 866-245-8064 | |
Mrs. Deborah Sue Cuper, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 417 3rd Ave., Clear Lake, WI 54005 Phone: 715-263-4103 Fax: 866-245-8064 |