Individual
JULIE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7727 PORTLAND AVE, RICHFIELD, MN 55423-4320
(612) 455-0304
Mailing address
7727 PORTLAND AVE, RICHFIELD, MN 55423-4320
(612) 455-0304
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
201883
MN
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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