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Individual

MR. GREGORY PAUL LADOUCEUR

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
155 WABASHA ST S, SUITE 130, SAINT PAUL, MN 55107-1801
(651) 291-7047
(651) 291-2505
Mailing address
1459 STANFORD AVE, SAINT PAUL, MN 55105-2416
(651) 690-2056

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4278
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4278
PT LICENSE
MN
Enumeration date
02/17/2006
Last updated
07/08/2007
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