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Individual

MS. LAURA MARIE LARSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTAL

Contact information

Practice address
119 OWENS ST N, GOOD SAMARITAN SYNERTX REHABILITATION, STILLWATER, MN 55082
(651) 439-7180
Mailing address
4675 DALE ST N, SHOREVIEW, MN 55126
(651) 484-9099

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
200519
MN

Other

Enumeration date
10/29/2007
Last updated
10/29/2007
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