Individual
LAURA BASTRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7505 COUNTRY CLUB DR, GOLDEN VALLEY, MN 55427-4501
(763) 450-6902
Mailing address
7505 COUNTRY CLUB DRIVE, GOLDEN VALLEY, MN 55427
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1673
MN
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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