Individual
SANDRA K LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
516 MONTGOMERY ST, DECORAH, IA 52101-2720
(563) 382-4770
(563) 382-4785
Mailing address
704 RIDGE RD, DECORAH, IA 52101-1120
(563) 382-4770
(563) 382-4785
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
03565
IA
2251P0200X
Pediatric Physical Therapist
03565
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34900
BLUE CROSS BLUE SHEILD
IA
01
—
F245962
MIDLANDS CHOICE
IA
01
—
TN0100
JOHN DEERE
IA
Enumeration date
06/05/2006
Last updated
09/11/2025
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