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1528190998
KELLY LARSON
WILLISTON, ND
NPI
1528190998
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: ND 643)
Enumeration Date
2007-03-12
Last Update Date
2007-07-08
Business Address
-- KELLY LARSON PTA
1301 15TH AVE W
WILLISTON, ND 58801-3821
Phone number: 701-774-7400
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Mailing Address
-- KELLY LARSON PTA
1301 15TH AVE W
WILLISTON, ND 58801-3821
Phone number: 701-774-7400
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