Individual
PAMELA JANE LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10150 W NATIONAL AVE, SUITE 150, MILWAUKEE, WI 53227-2145
(800) 439-7012
Mailing address
525 12TH AVE S, SOUTH ST PAUL, MN 55075-2715
(907) 232-8434
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1650
MN
Other
Enumeration date
03/11/2013
Last updated
03/11/2013
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