Individual
MICHAELA ANNE LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
Mailing address
11200 W RIVER RD, CHAMPLIN, MN 55316-3524
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12724
MN
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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