Individual
MIRANDA CATHLEEN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCTMB, LMT
Contact information
Practice address
112 UNIVERSITY DR N, STE 316, FARGO, ND 58102-4661
(218) 289-0276
Mailing address
112 UNIVERSITY DR N, STE 316, FARGO, ND 58102-4661
(218) 289-0276
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1539
ND
Other
Enumeration date
06/24/2010
Last updated
04/25/2017
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