Individual
MRS. DENISE ANNE EXSTROM LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3818 NORMAL BOULEVARD, LINCOLN, NE 68506
(402) 488-4282
(402) 488-6157
Mailing address
3818 NORMAL BOULEVARD, LINCOLN, NE 68506
(402) 488-4282
(402) 488-6157
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
661
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10024956500
—
NE
01
—
39619
BCBS
NE
01
—
650025850
RAIDROAD MEDICARE
NE
Enumeration date
02/01/2007
Last updated
10/29/2012
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