Individual
MRS. LACEY LYNN OPPERUD KONICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
3001 SANFORD PKWY, THIEF RIVER FALLS, MN 56701-2700
(701) 780-5000
(701) 780-1942
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9419
(701) 780-1942
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103465
MN
Other
Enumeration date
07/30/2007
Last updated
07/26/2024
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