Organization
LTC PROFESSIONALS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KURT LARSON (PRESIDENT)
(952) 479-4261
Entity
Organization
Contact information
Practice address
7801 EAST BUSH LAKE RD, SUITE 400, BLOOMINGTON, MN 55439
(952) 479-4261
(866) 991-7241
Mailing address
7801 EAST BUSH LAKE RD, SUITE 400, BLOOMINGTON, MN 55439
(952) 479-4261
(866) 991-7241
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
535
TONIC BIOREGULATORY MEDICINE
TN
Enumeration date
12/23/2010
Last updated
07/25/2024
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