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Individual

DR. SHELLY LEA LARSON-PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11091 ULYSSES ST, SUITE 100, BLAINE, MN 55434-4238
(612) 879-1000
(612) 879-9116
Mailing address
3601 MINNESOTA DR STE 200, BLOOMINGTON, MN 55435-5281
(612) 879-1000
(612) 879-9116

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
50897
MN

Other

Enumeration date
08/30/2007
Last updated
07/30/2023
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