Individual
ALEXIS LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4674 40TH AVE S STE A, FARGO, ND 58104-4501
(701) 293-7294
Mailing address
4674 40TH AVE S STE A, FARGO, ND 58104-4501
(701) 293-7294
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1992
ND
225100000X
Physical Therapist
9702
MN
Other
Enumeration date
06/02/2014
Last updated
10/31/2019
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