Ashwell, Larissa Mae
Ashwell, Larissa Mae is an sole proprietor health care provider with primary practice located at 101 N Bridge St Ste 1 , Chippewa Falls WI 54729-2483. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Mastectomy Fitter, which is considered as her primary health care specialty. Ashwell, Larissa Mae can be contacted via phone (715) 226-0775.Contact Information
Primary practice address
101 N Bridge St Ste 1
Chippewa Falls WI 54729-2483
Phone: (715) 226-0775
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Mastectomy Fitter | 224900000X | Wisconsin |
Profile Details
| NPI number | 1568989069 |
|---|---|
| LBN Legal business name | Ashwell, Larissa Mae |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 24th, 2017 |
| Last updated | Aug 24th, 2017 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568989069 | NPPES |
| Wisconsin | MEDICAID | 82-2373409 |
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