Individual
LARRY REED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
623 MADISON ST, BRAINERD, MN 56401-4518
(218) 829-5380
(218) 825-0972
Mailing address
623 MADISON ST, BRAINERD, MN 56401-4518
(218) 829-5380
(218) 825-0972
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
800
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088H2RE
BLUE CROSS BLUE SHIELD
MN
01
—
6406206
MEDICA
—
Enumeration date
09/19/2007
Last updated
09/19/2007
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