Individual
JOSHUA D LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6710
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282467000
—
MN
05
—
36170300
—
WI
01
—
650023913
RAILROAD MEDICARE
MN
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
01/27/2006
Last updated
10/05/2009
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