Individual
MR. RICHARD CARL LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
6276-024
WI
225100000X
Physical Therapist
Primary
6286
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316973266
AM PPO
—
01
—
182849
UCARE
—
05
—
36101900
—
WI
01
—
5751300001
DMERC
—
01
—
6406071
MEDICA
WI
01
—
81G96LA
BCBS
MN
01
—
B17211048332
PREFERRED ONE
—
01
—
HP61189
HEALTHPARTNERS
—
01
—
P00424481
RR MEDICARE
—
Enumeration date
06/23/2006
Last updated
03/28/2013
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