Individual
COREY M LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, ATC, CSCS
Contact information
Practice address
4040 RADIO DR, WOODBURY, MN 55129-3237
(651) 439-8804
(651) 439-0232
Mailing address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(952) 512-5600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13257
MN
225100000X
Physical Therapist
15631-24
WI
Other
Enumeration date
02/23/2017
Last updated
11/06/2023
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