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Individual

CLIFFORD W LAFRENIERE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
17261 STATE HWY 34, PARK RAPIDS, MN 56470
(218) 237-3052
(218) 237-2311
Mailing address
1425 S COLUMBIA RD, GRAND FORKS, ND 58201-4039
(701) 746-8374
(701) 780-0885

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2505
MN
225100000X
Physical Therapist
316
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2139952
FIRST HEALTH
ND
01
322R7LA
BCBS
MN
05
54780
ND
01
6404390
MEDICA
ND
Enumeration date
11/29/2006
Last updated
07/18/2007
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