Individual
PETER D LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
146 LAKE ST N, FOREST LAKE, MN 55025-2518
(651) 464-8502
(651) 464-8547
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9134
MN
Other
Enumeration date
08/15/2012
Last updated
06/22/2018
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