Provider Demographics
NPI:1851002802
Name:CORE CHOICE S.C.
Entity type:Organization
Organization Name:CORE CHOICE S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:715-724-2673
Mailing Address - Street 1:425 STATE ST.
Mailing Address - Street 2:P.O. BOX 1058
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54602
Mailing Address - Country:US
Mailing Address - Phone:715-724-2673
Mailing Address - Fax:
Practice Address - Street 1:1075 HICKORY ST
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-3022
Practice Address - Country:US
Practice Address - Phone:906-251-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty