Individual
LARS PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
257 RIVERTOWN DR, WOODBURY, MN 55125-7726
(651) 528-6461
(651) 528-6349
Mailing address
7581 9TH ST N STE 100, OAKDALE, MN 55128-6635
(651) 748-4338
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9742
MN
225100000X
Physical Therapist
—
—
Other
Enumeration date
07/31/2014
Last updated
07/20/2021
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